Diabetes, the Flu Shot, and Other Recommended Vaccinations
People with diabetes are urged to get their flu and COVID-19 vaccines each fall, plus other key vaccines that protect year-round. Here’s what’s recommended, when to get them, and why vaccination is especially important if you have diabetes.
The American Diabetes Association (ADA) recommends people with diabetes get a flu shot every year in early fall, ideally by the end of October, but it's not too late to get vaccinated in November or even December. Flu season usually peaks between December and January, but it can run all the way into March or April. The ADA and the Centers for Disease Control and Prevention (CDC) also recommend that everyone in your household get a flu shot.
There are several kinds of flu vaccines that people can receive.
- Flu shots (injected): Recommended for people with diabetes.
- High-dose and adjuvanted vaccines: Stronger and made for people 65 and older.
- Recombinant and cell-based vaccines: Not produced in eggs – a good option for people with an egg allergy.
- Nasal spray (live attenuated): Not recommended for people with diabetes.
- Jet injector (no needle): Approved for people between the ages of 18 and 64.
Talk with your healthcare team about your flu vaccine options to determine which is best for you. Most U.S. insurance plans – including Medicare Part B and many state Medicaid programs – cover flu shots at no cost. Protection begins about two weeks after vaccination and lasts around six months.
Vaccines are available through healthcare providers and local pharmacies – you can find one near you using the VaccineFinder.org site. The ADA and CDC also recommend that people with diabetes get the COVID-19 booster each fall. The CDC advises that it's safe to receive a flu shot and a COVID-19 booster at the same visit.
Mild flu-like symptoms, such as fever, chills, body aches, sore throat, cough, and a runny nose, can be normal after a vaccine, but if symptoms are persistent or severe, contact your healthcare team.
Why are vaccines important?
Each year, a new flu vaccine is created to provide protection from new strains that scientists predict will be most prevalent. In years when the vaccine is well-matched to the virus, it reduces a person’s risk of illness by 40-60%. For the 2023-2024 season, the CDC estimated that flu vaccination prevented 9.8 million illnesses, 120,000 hospitalizations, and nearly 8,000 deaths.
Diabetes can complicate the recovery from both the flu and COVID-19 due to fluctuating glucose levels and a weakened immune system. Getting vaccinated helps prevent infection and can reduce the severity if you do get sick.
“If an individual does get the flu, being vaccinated helps them avoid more serious health consequences," said Dr. Robert Gabbay, former ADA chief scientific and medical officer.
Being sick with the flu can also make it more difficult to manage your diabetes. Gabbay noted that after being diagnosed with the flu, people with diabetes may see more hyperglycemia (high blood sugar) and are at higher risk for pneumonia, coronary heart disease, and sepsis, which is inflammation resulting from an immune response to infection.
Year-round protection
The flu shot and COVID-19 vaccines aren’t the only immunizations that protect people with diabetes. The ADA recommends several others based on age and risk:
Pneumococcal (pneumonia)
People with diabetes face an increased risk of pneumonia. Viral infections like the flu, COVID-19, and respiratory syncytial virus (RSV) can also be complicated by pneumonia. Vaccination significantly lowers the risk of pneumonia, sepsis, and meningitis.
- Adults 19-64 with diabetes receive one dose of PCV15 or PCV20, following CDC and ADA recommendations.
- If PCV15 is used, a PPSV23 dose is advised at least one year later (or after eight weeks for those with immunocompromising conditions).
- Adults 65 and older who have not previously received a pneumococcal conjugate vaccine should also receive PCV15 or PCV20 as part of routine care.
Respiratory syncytial virus (RSV)
The ADA recommends adults 60 and older should receive one dose of the RSV vaccine after discussion with their healthcare provider.
Tdap/Td (tetanus, diphtheria, pertussis)
One Tdap dose is given in adulthood, followed by a Td or Tdap booster every 10 years. Those who are pregnant should receive an extra dose.
Shingles
A two-dose series of the Shingrix vaccine is recommended for adults 50 and older.
Hepatitis B
The hepatitis B vaccine is advised for adults with diabetes under 60. Adults 60 and older can also get the vaccine if their doctor determines they’re at risk.
The bottom line
Infections like flu, pneumonia, and COVID-19 can cause serious complications for people with diabetes, including swings in blood sugar, dehydration, and increased risk of heart events. Vaccination provides protection against these complications.
Following preventive steps like mask-wearing when sick, handwashing, and avoiding close contact when ill adds further protection through the winter and beyond.
Learn more about flu prevention and staying well with diabetes here: