AACE supports the recommendations of the CDC Advisory Committee on Immunization Practices (ACIP) that all persons with diabetes mellitus receive age-appropriate vaccinations according to the CDC/ACIP schedule. An important section of the 2022 AACE Diabetes Guideline is Question 28: Which vaccinations should be given to persons with diabetes mellitus? Within that section are 11 recommendations and the evidence base for each on the types of vaccines adults with diabetes should receive.

Table 21 of the guideline (as shown below) provides a concise list of vaccine recommendations for persons with diabetes mellitus that a professional can refer to when discussing individual vaccination concerns with their patients.

Vaccine Recommendations for Adults with Diabetes Mellitus*

VaccineRecommendationGrade and Best Evidence Level
All persons should receive according to the CDC/ACIP immunization schedules: www.cdc.gov/vaccines/schedules/index.htmlA 4
IIV4 or RIV4
AnnuallyA 1
PCV15 and PCV20
Ages 19-64 years
PCV15 or PCV20 for all adults aged 19-64 years who have underlying medical conditions, including DM. When PCV15 is used, PPSV23 should be administered at least 12 months following the dose of PCV15. A minimum interval of 8 weeks may be used for adults with immunocompromising conditions.B 3
PCV15 and
Ages ≥65 years
For adults over age 65 who have not previously received PCV or whose vaccination history is unknown, PCV15 or PCV20 should be administered. When PCV15 is used, it should be followed by a dose of PPSV23.B 3
Hepatitis B
All adults ≤59 years
Based on risk and quality of immune response for adults ≥60 years
A 1
C 4
acellular pertussis
Every 10 years following completion of the primary seriesC 4
COVID-19All persons per FDA approval or emergency use authorizationB 2
All adults ≥50 yearsA 1

*For child/adolescent specific immunization recommendations, refer to the CDC Immunization Schedules

Reprinted from Endocrine Practice, Vol 28, Blonde L, Umpierrez G, McGill JB, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan—2022 Update, 2022. doi: 10.1016/j.eprac.2022.08.002, with permission from AACE.

ACIP = Advisory Committee on Immunization Practices; CDC = Centers for Disease Control and Prevention; COVID-19 = coronavirus disease 2019; DM = diabetes mellitus; FDA = Food and Drug Administration; IIV4 = quadrivalent inactivated influenza vaccine; LAIV = live, attenuated influenza vaccine; PCV15 and PCV20 = pneumococcal conjugate vaccines; PPSV23 = pneumococcal polysaccharide vaccine; RIV4 = quadrivalent recombinant influenza vaccine; RZV = recombinant zoster vaccine

This resource is provided by AACE, through the grant Specialty Societies Advancing Adult Immunizations, funded by the CDC and coordinated through the Council on Medical Specialty Societies. Learn more

Read the full guideline