Immunization Coverage and Outcomes in Nearly 620,000 Patients with Diabetes
Overview
In a large cohort of 618,396 patients with type 1 and type 2 diabetes in Lombardy, Italy, immunization coverage was suboptimal, with 44.6% receiving influenza vaccine and much lower rates for pneumococcus, meningococcus, and herpes zoster vaccines. Vaccinated patients showed a significant reduction in mortality and hospitalizations, particularly among older individuals.
Background
Patients with diabetes are at increased risk for infectious diseases and related complications, including hospitalization and death. Influenza, pneumococcal disease, herpes zoster, and meningococcal infections are notable concerns in this population. Vaccination is recommended to reduce morbidity and mortality, but data on coverage and effectiveness in diabetes are limited. This study evaluates immunization coverage and associated outcomes in a large diabetic population within the Lombardy healthcare system.
Data Highlights
Vaccine
Coverage in Patients with Diabetes (%)
Influenza
44.6
Pneumococcal
10.9
Meningococcus
2.5
Herpes Zoster
0.7
Key Findings
Only 44.6% of patients with diabetes received the influenza vaccine during the 2021-2022 campaign.
Pneumococcal, meningococcal, and herpes zoster vaccine coverage were markedly lower at 10.9%, 2.5%, and 0.7%, respectively.
Vaccinated patients had approximately a 2-fold reduction in overall mortality risk and decreased hospitalizations compared to unvaccinated patients.
Older vaccinated patients exhibited a 3-fold lower mortality risk and fewer hospitalizations for cardiac and pulmonary causes.
Influenza vaccination alone prevented nearly 3,800 deaths per 100,000 patients with diabetes.
Clinical Implications
Despite clear benefits, immunization coverage among patients with diabetes remains below recommended targets, highlighting a critical gap in preventive care. Clinicians should prioritize vaccination counseling and administration for influenza, pneumococcus, meningococcus, and herpes zoster to reduce mortality and hospitalization risks in this vulnerable population. Enhanced public health efforts are needed to scale up vaccination programs tailored for patients with diabetes.
Conclusion
This large-scale study demonstrates that vaccination significantly reduces mortality and hospitalizations in patients with diabetes, yet coverage remains insufficient. Strengthening immunization efforts is essential to improve outcomes in this high-risk group.
References
Regional Government of Lombardy 2023 -- Immunization Profile Among Nearly 620,000 Individuals with Diabetes
by Francesca D’Addio, Elisa Lazzaroni, Maria Elena Lunati, Giuseppe Preziosi, Michele Ercolanoni, Giulio Turola, Chiara Marrocu, Giovanni Cicconi, Sudwaric Sharma, Simona Scarioni, Laura Montefusco, Ida Pastore, Paola Silvia Morpurgo, Antonio Rossi, Alessandra Gandolfi, Camilla Tinari, Giada Rossi, Moufida Ben Nasr, Cristian Loretelli, Roberta Maria Fiorina, Baldassarre Grassa, Rosa Terranova, Loredana Bucciarelli, Cesare Berra, Danilo Cereda, Gianvincenzo Zuccotti, Catia Rosanna Borriello, Paolo Fiorina
