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CDC Advisory Committee Recommends Hepatitis B Vaccine for People with Diabetes

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) last week recommended that adults up to age 60 with diabetes should be vaccinated against hepatitis B virus (HBV), as this group has a higher risk of infection compared with the general population.

Research has shown that diabetics under age 60 are about twice as likely as non-diabetics to become infected with HBV, according to a Reuters report. This is thought to be attributable to non-sterile blood glucose monitoring equipment, for example finger-stick devices used on more than one person.

Trudy Murphy, director of the CDC's Division of Viral Hepatitis vaccine unit, said that most hepatitis B outbreaks at long-term care facilities could be traced to blood glucose monitors.

This elevated risk was not seen for diabetics over age 60 -- even though older people are more likely to spend time in such facilities -- and older individuals are less likely to respond strongly to vaccination. However, the advisory committee said the HBV vaccine was optional for this age group.

This is the first time ACIP has included diabetics among its list of at-risk adults who should be vaccinated against HBV, which includes men who have sex with men, people with multiple sex partners, patients with chronic liver or kidney disease, and emergency response and healthcare workers who may be exposed to blood on the job. For 2 decades the HBV vaccine has been part of the routine series of childhood immunizations, and "catch up" vaccination is recommended for adolescents who have not yet received it.

Two hepatitis B vaccines are currently approved in the U.S., Merck's Recombivax and GlaxoSmithKline's Engerix-B; a combination hepatitis A and B vaccine (Twinrix) is also available.

The CDC is not required to follow ACIP's recommendation, but it typically does so, especially when the committee's vote is strongly in favor, as it was in this case (12-2).

11/1/11

Sources

E Hitt. ACIP Recommends HBV Vaccine in Patients With Diabetes. Medscape Medical News. October 26, 2011.

A Selyukh. U.S. Advisers Recommend Diabetics Get Hep B Vaccine. Reuters. October 25, 2011.