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COVID-19 Vaccination in Persons with Diabetes: How to Approach Patients

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Diabetes and COVID-19

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Since SARS-CoV-2 was first identified as the cause of a cluster of cases of pneumonia in the Hubei Province in China in late 2019, the development and distribution of effective vaccines to prevent severe illness and death from the disease has been a major global priority. Because of the initial concerns about worse disease severity and prognosis in the setting of diabetes mellitus, people with diabetes were an early priority for these vaccines as they became available. The rapid development of vaccines is a remarkable story of collaboration in the scientific community and has become one of the most effective ways to mitigate the impact of the COVID-19 pandemic. This chapter explores what is known about the general approach to vaccination, the duration of vaccines, the impact vaccines have had on hospitalization and mortality in persons with diabetes and COVID-19, and strategies to improve vaccine confidence in patients living with diabetes.

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References

  1. Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study. Clin Infect Dis. 2020;71(15):889–90.

    Article  CAS  PubMed  Google Scholar 

  2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Bashir S, Alabdulkarim N, Altwaijri N, Alhaidri N, Hashim R, Nasim E, et al. The battle against the COVID-19 pandemic—a perspective from Saudi Arabia. One Health. 2021;12:100229.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: a review of pathogenesis. Indian J Endocrinol Metab. 2012;16(Suppl 1):S27–36.

    PubMed  PubMed Central  Google Scholar 

  5. Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Fadini GP, Morieri ML, Longato E, Avogaro A. Prevalence and impact of diabetes among people infected with SARS-CoV-2. J Endocrinol Invest. 2020;43(6):867–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – a systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14(4):395–403.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Huang Y, Yang C, Xu X, Liu SW. Structural and functional properties of SARS-CoV-2 spike protein: potential antivirus drug development for COVID-19. Acta Pharmacologica Sinica. 2020;3(41):1141–9.

    Article  Google Scholar 

  9. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Krammer F. SARS-CoV-2 vaccines in development. Nature. 2020;586(7830):516–27.

    Article  CAS  PubMed  Google Scholar 

  11. Alqassieh R, Suleiman A, Abu-Halaweh S, Santarisi A, Shatnawi O, Shdaifat L, et al. Pfizer-BioNTech and Sinopharm: a comparative study on post-vaccination antibody titers. Vaccines (Basel). 2021;9(11):1223.

    Article  CAS  PubMed  Google Scholar 

  12. Lampasona V, Secchi M, Scavini M, Bazzigaluppi E, Brigatti C, Marzinotto I, et al. Antibody response to multiple antigens of SARS-CoV-2 in patients with diabetes: an observational cohort study. Diabetologia. 2020;63(12):2548–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Karamese M, Tutuncu EE. The effectiveness of inactivated SARS-CoV-2 vaccine (CoronaVac) on antibody response in participants aged 65 years and older. J Med Virol. 2022;94(1):173–7.

    Article  CAS  PubMed  Google Scholar 

  14. D’Addio F, Sabiu G, Usuelli V, Assi E, Abdelsalam A, Maestroni A, et al. Immunogenicity and safety of SARS-CoV-2 mRNA vaccines in a cohort of patients with type 1 diabetes. Diabetes. 2022;71(8):1800–6.

    Article  PubMed  Google Scholar 

  15. Goldberg Y, Mandel M, Bar-On YM, Bodenheimer O, Freedman L, Haas EJ, et al. Waning immunity after the BNT162b2 vaccine in Israel. N Engl J Med. 2021;385(24):e85.

    Article  CAS  PubMed  Google Scholar 

  16. Rosenberg ES, Holtgrave DR, Dorabawila V, Conroy M, Greene D, Lutterloh E, et al. New COVID-19 cases and hospitalizations among adults, by vaccination status - New York, May 3-July 25, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(34):1150–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Feikin DR, Higdon MM, Abu-Raddad LJ, Andrews N, Araos R, Goldberg Y, et al. Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression. Lancet. 2022;399(10328):924–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Andrews N, Tessier E, Stowe J, Gower C, Kirsebom F, Simmons R, et al. Duration of protection against mild and severe disease by Covid-19 vaccines. N Engl J Med. 2022;386(4):340–50.

    Article  CAS  PubMed  Google Scholar 

  19. Yek C, Warner S, Wiltz JL, Sun J, Adjei S, Mancera A, et al. Risk Factors for severe COVID-19 outcomes among persons who completed primary COVID-19 vaccination series. MMWR Morb Mortal Wkly Rep. 2022;71(1):19–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Thompson MG, Natarajan K, Irving SA, Rowley EA, Griggs EP, Gaglani M, et al. Effectiveness of a third dose of mRNA vaccines against COVID-19-associated emergency department and urgent care encounters and hospitalizations among adults during periods of Delta and Omicron variant predominance - VISION Network, 10 states, August 2021-January 2022. MMWR Morb Mortal Wkly Rep. 2022;71(4):139–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Moreira ED Jr, Kitchin N, Xu X, Dychter SS, Lockhart S, Gurtman A, et al. Safety and efficacy of a third dose of BNT162b2 Covid-19 vaccine. N Engl J Med. 2022;386(20):1910–21.

    Article  CAS  PubMed  Google Scholar 

  22. CDC recommends the first updated COVID-19 booster; 1 Sep 2022. https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html. Accessed 9 Sep 2022.

  23. Interim clinical considerations for COVID-19 vaccines: bivalent boosters. ACIP; 1 Sep 2022. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2022-09-01/09-covid-hall-508.pdf. Accessed 9 Sep 2022.

  24. Rosenblum HG, Wallace M, Godfrey M, Roper LE, Hall E, Fleming-Dutra KE, et al. Interim recommendations from the advisory committee on immunization practices for the use of bivalent booster doses of COVID-19 vaccines—United States, October 2022. MMWR Morb Mortal Wkly Rep. 2022;71(45):1436–41.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Coronavirus (COVID-19) update: FDA authorizes updated (bivalent) covid-19 vaccines for children down to 6 months of age; 8 Dec 2022. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-updated-bivalent-covid-19-vaccines-children-down-6-months. Accessed 29 Dec 2022.

  26. Puig-Domingo M, Marazuela M, Yildiz BO, Giustina A. COVID-19 and endocrine and metabolic diseases. An updated statement from the European Society of Endocrinology. Endocrine. 2021;72(2):301–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Rao GHR. Twindemic of coronavirus disease (COVID-19) and cardiometabolic diseases. Int J Biomedicine. 2021;11(2):111–22.

    Article  Google Scholar 

  28. Yang JK, Feng Y, Yuan MY, Yuan SY, Fu HJ, Wu BY, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabet Med. 2006;23(6):623–8.

    Article  CAS  PubMed  Google Scholar 

  29. Holman N, Knighton P, Kar P, O’Keefe J, Curley M, Weaver A, et al. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. Lancet Diabetes Endocrinol. 2020;8(10):823–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Myers AK, Kim TS, Zhu X, Liu Y, Qiu M, Pekmezaris R. Predictors of mortality in a multiracial urban cohort of persons with type 2 diabetes and novel coronavirus 19. J Diabetes. 2021;13(5):430–8.

    Article  CAS  PubMed  Google Scholar 

  31. McGovern AP, Thomas NJ, Vollmer SJ, Hattersley AT, Mateen BA, Dennis JM. The disproportionate excess mortality risk of COVID-19 in younger people with diabetes warrants vaccination prioritization. Diabetologia. 2021;64(5):1184–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Powers AC, Aronoff DM, Eckel RH. COVID-19 vaccine prioritisation for type 1 and type 2 diabetes. Lancet Diabetes Endocrinol. 2021;9(3):140–1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Gregory JM, Slaughter JC, Duffus SH, Smith TJ, LeStourgeon LM, Jaser SS, et al. COVID-19 severity is tripled in the diabetes community: a prospective analysis of the pandemic’s impact in type 1 and type 2 diabetes. Diabetes Care. 2021;44(2):526–32.

    Article  CAS  PubMed  Google Scholar 

  34. Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H, et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8(10):813–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. O’Malley G, Ebekozien O, Desimone M, Pinnaro CT, Roberts A, Polsky S, et al. COVID-19 hospitalization in adults with type 1 diabetes: results from the T1D exchange multicenter surveillance study. J Clin Endocrinol Metab. 2021;106(2):e936–42.

    Article  PubMed  Google Scholar 

  36. Wargny M, Gourdy P, Ludwig L, Seret-Bégué D, Bourron O, Darmon P, et al. Type 1 diabetes in people hospitalized for COVID-19: new insights from the CORONADO study. Diabetes Care. 2020;43(11):e174–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Afshar ZM, Babazadeh A, Janbakhsh A, Mansouri F, Sio TT, Sullman MJM, et al. Coronavirus disease 2019 (Covid-19) vaccination recommendations in special populations and patients with existing comorbidities. Rev Med Virol. 2021;22:e2309.

    Google Scholar 

  38. Dispinseri S, Lampasona V, Secchi M, Cara A, Bazzigaluppi E, Negri D, et al. Robust neutralizing antibodies to SARS-CoV-2 develop and persist in subjects with diabetes and COVID-19 pneumonia. J Clin Endocrinol Metab. 2021;106(5):1472–81.

    Article  PubMed  Google Scholar 

  39. Dooling K, Marin M, Wallace M, McClung N, Chamberland M, Lee GM, et al. The advisory Committee on Immunization practices’ updated interim recommendation for allocation of COVID-19 vaccine—United States, December 2020. MMWR Morb Mortal Wkly Rep. 2021;69:1657–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. World Health Organization. WHO SAGE roadmap for prioritizing use of COVID-19 vaccines; 21 Jan 2022. https://www.who.int/publications/i/item/WHO-2019-nCoV-Vaccines-SAGE-Prioritization-2022.1. Accessed 29 Dec 2022.

  41. American Diabetes Association applauds CDC decision to prioritize all people with diabetes for the COVID-19 vaccine; 30 Mar 2021. https://diabetes.org/official-statements/2021/ADA-applauds-CDC-decision-to-prioritize-all-pwd-for-covid-19-vaccine. Accessed 29 Dec 2022.

  42. Hur KY, Moon MK, Park JS, Kim SK, Lee SH, Yun JS, Committee of Clinical Practice Guidelines, Korean Diabetes Association, et al. 2021 clinical practice guidelines for diabetes mellitus of the Korean Diabetes Association. Diabetes Metab J. 2021;45(4):461–81.

    Article  PubMed  PubMed Central  Google Scholar 

  43. European Society of Endocrinology (ESE)’s statement concerning COVID-19 vaccination: ‘follow the same recommendations for patients with stable endocrine disorders as for the general population’; February 2021. https://www.ese-hormones.org/news/ese-news/european-society-of-endocrinology-ese-s-statement-concerning-covid-19-vaccination-follow-the-same-recommendations-for-patients-with-stable-endocrine-disorders-as-for-the-general-population/. Accessed 15 Feb 2022.

  44. Sculli MA, Formoso G, Sciacca L. COVID-19 vaccination in pregnant and lactating diabetic women. Nutr Metab Cardiovasc Dis. 2021;31(7):2151–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Blakeway H, Prasad S, Kalafat E, Heath PT, Ladhani SN, Le Doare K, et al. COVID-19 vaccination during pregnancy: coverage and safety. Am J Obstet Gynecol. 2022;226(2):236.e1–236.e14.

    Article  CAS  PubMed  Google Scholar 

  46. World Health Organization. Ten threats to global health in 2019. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. Accessed 7 Sep 2022.

  47. MacDonald NE and the SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34):4161–4.

    Article  Google Scholar 

  48. Marcelin JR, Swartz TH, Bernice F, Berthaud V, Christian R, da Costa C, et al. Addressing and inspiring vaccine confidence in Black, Indigenous and People of Color during the Coronavirus Disease 2019 pandemic. Open Forum Infect Dis. 2021;8(9):ofab417.

    Article  PubMed  PubMed Central  Google Scholar 

  49. World Health Organization. Infodemic. https://www.who.int/health-topics/infodemic#tab=tab_1. Accessed 7 Sep 2022.

  50. Loomba S, de Figueiredo A, Piatek SJ, de Graaf K, Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat Hum Behav. 2021;5(3):337–48.

    Article  PubMed  Google Scholar 

  51. Fridman A, Gershon R, Gneezy A. COVID-19 and vaccine hesitancy: a longitudinal study. PLoS One. 2021;16(4):e0250123.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Savoia E, Piltch-Loeb R, Goldberg B, Miller-Idriss C, Hughes B, Montrond A, et al. Predictors of COVID-19 vaccine hesitancy: socio-demographics, co-morbidity, and past experience of racial discrimination. Vaccines. 2021;9(7):767.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Hamel L, Lopes L, Muñana, C, Artiga S, Brodie M. Kaiser Family Foundation (KFF). Race, health and COVID-19: the views and experiences of Black Americans. Key findings from the KFF/undefeated survey on race and health. https://files.kff.org/attachment/Report-Race-Health-and-COVID-19-The-Views-and-Experiences-of-Black-Americans.pdf. Accessed 9 Sep 2022.

  54. Painter JE, Viana De O, Mesquita S, Jimenez L, Avila AA, Sutter CJ, Sutter R. Vaccine-related attitudes and decision-making among uninsured, Latin American immigrant mothers of adolescent daughters: a qualitative study. Hum Vaccin Immunother. 2019;15(1):121–33.

    Article  PubMed  Google Scholar 

  55. Hildreth JEK, Alcendor DJ. Targeting COVID-19 Vaccine Hesitancy in Minority Populations in the US: Implications for Herd Immunity. Vaccines (Basel). 2021;9(5):489.

    Article  CAS  PubMed  Google Scholar 

  56. Gatwood J, McKnight M, Fiscus M, Hohmeier KC, Chisholm-Burns M. Factors influencing likelihood of COVID-19 vaccination: a survey of Tennessee adults. Am J Health Syst Pharm. 2021;78(10):879–89.

    Article  PubMed  Google Scholar 

  57. Scoccimarro D, Panichi L, Ragghianti B, et al. Sars-CoV2 vaccine hesitancy in Italy: a survey on subjects with diabetes. Nutr Metab Cardiovasc Dis. 2021;31(11):3243–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Al-Hanawi MK, Ahmad K, Haque R. Willingness to receive COVID-19 vaccination among adults with chronic diseases in the Kingdom of Saudi Arabia. J Infect Public Health. 2021;14(10):1489–96.

    Article  PubMed  Google Scholar 

  59. Bongomin F, Olum R, Andia-Biraro I, et al. COVID-19 vaccine acceptance among high-risk populations in Uganda. Ther Adv Infect Dis. 2021;9(8):20499361211024376.

    Google Scholar 

  60. Abedin M, Islam MA, Rahman FN, Reza HM, Hossain MZ, Hossain MA, et al. Willingness to vaccinate against COVID-19 among Bangladeshi adults: Understanding the strategies to optimize vaccination coverage. PLoS One. 2021;16(4):e0250495.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Al-Marshoudi S, Al-Balushi H, Al-Wahaibi A, et al. Knowledge, attitudes, and practices (Kap) toward the covid-19 vaccine in Oman: a pre-campaign cross-sectional study. Vaccines (Basel). 2021;9(6):602.

    Article  CAS  PubMed  Google Scholar 

  62. Umakanthan S, Patil S, Subramaniam N, et al. COVID-19 vaccine hesitancy and resistance in India explored through a population-based longitudinal survey. Vaccines (Basel). 2021;9(10):1064.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Syed Alwi SAR, Rafidah E, Zurraini A, Juslina O, Brohi IB, Lukas S. A survey on COVID-19 vaccine acceptance and concern among Malaysians. BMC Public Health. 2021;21(1):1129.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Rutten LJ, Zhu X, Leppin AL, Ridgeway JL, Swift MD, Griffin JM, et al. Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. Mayo Clin Proc. 2021;96(3):699–707.

    Article  Google Scholar 

  65. Bogart LM, Dong L, Gandhi P, Klein DJ, Smith TL, Ryan S, Ojikutu BO. COVID-19 vaccine intentions and mistrust in a National Sample of Black Americans. J Natl Med Assoc. 2022;113(6):599–611.

    PubMed  Google Scholar 

  66. Chu J, Pink SL, Willer R. Religious identity cues increase vaccination intentions and trust in medical experts among American Christians. Proc Natl Acad Sci U S A. 2021;118(49):e2106481118.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Diament SM, Kaya A, Magenheim EB. Frames that matter: increasing the willingness to get the Covid-19 vaccines. Soc Sci Med. 2022;292:114562.

    Article  PubMed  Google Scholar 

  68. Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: how many people would get vaccinated? Vaccine. 2020;38(42):6500–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Centers for Disease Control. Talking with patients about COVID-19 vaccination. https://www.cdc.gov/vaccines/covid-19/hcp/engaging-patients.html. Accessed 9 Sep 2022.

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Authors and Affiliations

  1. Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Matthew T. Crow

  2. Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Erica N. Johnson

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Correspondence to Erica N. Johnson .

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  1. Division of Endocrinology, Department of Medicine, Montefiore Einstein, Bronx, NY, USA

    Alyson K. Myers

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Crow, M.T., Johnson, E.N. (2023). COVID-19 Vaccination in Persons with Diabetes: How to Approach Patients. In: Myers, A.K. (eds) Diabetes and COVID-19. Contemporary Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-031-28536-3_12

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