8 Questions People With Diabetes Must Ask About the Coronavirus Vaccines

Vaccines for COVID-19 are increasingly available to more American adults, with 19 states now offering vaccinations to anyone ages 16 years and older, and President Biden recommending all adults be eligible for vaccination by May 1.

It is especially important for people with type 1 or type 2 diabetes to receive vaccinations for COVID-19 because they are at increased risk for severe illness and death from the novel coronavirus, as the Centers for Disease Control and Prevention (CDC) notes. You may have questions about these new vaccines, including when you can get them and what questions you should ask your doctor about them. Experts we talked with say the vaccines are safe, effective, and important for people with diabetes.

“The most important thing is that people with diabetes get vaccinated as soon as it becomes available to them,” says Robert Gabbay, MD, PhD, chief science and medical officer for the American Diabetes Association (ADA) in Arlington, Virginia.

Below, we detail what you need to know about the COVID-19 vaccines.

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1. When Will I Be Able to Get the Vaccine if I Have Diabetes?
It depends on where you live. At a federal level, the CDC makes recommendations about who should receive priority for vaccination. It is then up to each state to use those recommendations to plan for and distribute vaccines to counties and residents.

States such as Texas and Ohio are among states that offer vaccines to anyone ages 16 and older, including those with diabetes. Most other states have projected dates in April or May when everyone 16 and up will be eligible, according to the Kaiser Family Foundation.

So where does that put people with diabetes? Since vaccines became available, the CDC has recommended that people with type 2 diabetes and other underlying medical conditions receive priority due to their increased risk of severe COVID-19-associated illness. However, federal guidelines did not include people with type 1 diabetes until recently.

On March 29, the CDC updated its website to state that “having either type 1 or type 2 diabetes can make you more likely to get severely ill from COVID-19.” This followed advocacy at the federal and state level from groups including the Juvenile Diabetes Research Foundation (JDRF) and the ADA.

“The ADA has also been working with governors across the nation to advocate for prioritizing vaccine access for type 1 and type 2 diabetes equally; as of this writing, 38 states and the District of Columbia have announced they will take this step,” says ADA CEO Tracey D. Brown in a statement.

Justin Gregory, MD, assistant professor of pediatrics at Vanderbilt Children’s Hospital in Nashville, Tennessee, who has type 1 diabetes, says equal vaccine prioritization for people with type 1 or type 2 diabetes is important because both groups have a similarly increased risk for dangerous and deadly COVID-19 illness.

In the end, states make their own decisions about vaccination priority, so check your state and local health department’s website to find out when you are eligible. The ADA has also assembled links to individual states’ vaccination plans as part of its COVID-19 Vaccination Guide.

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2. Do Additional Factors, Such as Age or Having Another Health Condition, Affect My Place in Line?
Potentially. In states like Colorado, people ages 16 to 49 with one high-risk condition, such as type 1 or type 2 diabetes, and people 50 years or older became eligible for vaccination on March 19. Again, it comes down to where you live.

In Massachusetts, for example, people with two or more underlying conditions such as type 2 diabetes have been prioritized to get a COVID-19 vaccine, while those with only one condition will be eligible on April 5. Other states do not designate priority by the number of underlying medical conditions.

3. Where Can I Get a COVID-19 Vaccine Once People With Diabetes Are Allowed?
Where you can get a vaccine also varies depending on where you live. You may be able to sign up for notification about availability of the vaccine with your county or healthcare provider. Pharmacies, hospitals, doctors’ offices, and health departments are all playing a role in administering the vaccines. Your doctor can also guide you on where to seek a vaccine in your hometown.

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4. Are COVID-19 Vaccines Free for People With Diabetes?
The COVID-19 vaccine is free for everyone, regardless of diabetes status, according to the CDC. But some providers administering the vaccine may charge a fee, which can be reimbursed by your public or private health insurance, or by the Health Resources and Services Administration’s Provider Relief Fund if you do not have insurance.

5. Why Is It Important to Get the Vaccine if You Have Diabetes?
“It’s quite clear that people with diabetes do much worse than people without diabetes in terms of their outcomes with COVID,” says Dr. Gabbay. Early in the pandemic, a study from the CDC, published in July 2017 in the Morbidity and Mortality Weekly Report, found that roughly half of people who died from COVID-19 under age 65 had diabetes.

The protective effects of vaccines are critical for people with diabetes who are at increased risk for severe and deadly infection from COVID-19, says Dr. Gregory. His December 2020 study in Diabetes Care suggested that people with type 1 or type 2 diabetes are 3 times more likely to be hospitalized or experience severe COVID-19 illness compared with people without diabetes.

Two studies from the United Kingdom showed similar risk. An October 2020 study in The Lancet Diabetes & Endocrinology found that people with type 1 or type 2 diabetes were 2 to 3 times more likely to die from COVID-19 in the hospital than people without diabetes. And a December 2020 study in The Lancet Diabetes & Endocrinology found that people with type 1 or type 2 were more likely to die or to be treated in the intensive care unit for COVID-19.

Vaccinations for Black, Latino, and Native Americans are critical because these communities are disproportionately affected by both diabetes and COVID-19. African Americans and Latino Americans are over 50 percent more likely to have diabetes than white Americans, according to the ADA. Black, Latino, and Native Americans experienced a death rate from COVID-19 double or more than white Americans in 2020, according to the CDC.

RELATED: Black Americans Have Been Hit Hardest by COVID-19 — Here’s Why

6. Are the Vaccines Safe and Effective for People With Diabetes?
Three COVID-19 vaccines are currently available in the United States — and people with diabetes were included in all three vaccine trials.

Two vaccines require two doses spaced either 21 days (Pfizer-BioNTech vaccine) or 28 days (Moderna vaccine) apart. With their two doses completed, these vaccines are over 90 percent effective and received emergency use authorization from the U.S. Food and Drug Administration (FDA) in December 2020. A study of of 4,000 individuals, including healthcare workers and first responders, published in March 2021 in the Morbidity and Mortality Weekly Report, observed that those who were fully vaccinated with either the Moderna or Pfizer vaccine were 90 percent less likely to get infected with COVID-19.

The one-dose Johnson & Johnson vaccine is 66 percent effective at preventing moderate to severe COVID-19 disease 28 days after vaccination in clinical trials around the world; in U.S. trials it was 72 percent effective, according to phase 3 clinical trials. There were no deaths or hospitalizations from COVID-19 among people vaccinated during the J&J clinical trial. It received emergency use authorization from the FDA on February 27, 2021.

C. Buddy Creech, MD, MPH, is director of the Vanderbilt Vaccine Research Program in Nashville, Tennessee, was part of the phase 3 trials of the Moderna COVID-19 vaccine. “We wanted to make sure we recruited a number of individuals who had the types of underlying medical conditions that can make COVID more severe,” Dr. Creech says.

That included people with diabetes, hypertension, and obesity, he adds. The vaccines were well tolerated, highly efficacious, and elicited an immune response in people with underlying conditions, such as diabetes, says Creech.

People with type 1, type 2, and gestational diabetes participated in the Moderna clinical trial, he adds. The FDA filing from Pfizer-BioNTech says the trial included people with diabetes but does not specify among types. And the FDA filing from J&J says the trial included people with type 1 and type 2 diabetes.

“People with diabetes are going to be prioritized [for COVID-19 vaccination] because we know they’re at increased risk for disease. And they should feel confident that someone a whole lot like them was enrolled in the clinical trial so that we can say with a greater degree of certainty that they can effectively get this vaccine,” says Creech.

Gabbay says that the data do not suggest the COVID-19 vaccines pose particular risk for people with diabetes. He also says there is no reason to think there would be interactions with insulin or other medications that people with diabetes might take.

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7. What Side Effects of the Vaccine Should People With Diabetes Pay Attention To?
In general, the most common side effects of both vaccines are pain, swelling, and redness at the injection site. Other common side effects are chills, tiredness, and headaches. Most of these side effects were mild, but some people had more severe reactions that interfered with daily activities.

Gabbay says side effects of the COVID-19 vaccines are similar to those of flu vaccines. For someone living with diabetes, keeping a sick-day kit with extra medications and supplies is beneficial in case you do not feel well.

8. What Questions Should People With Diabetes Ask Their Healthcare Teams About the COVID-19 Vaccines?
Gabbay says the first question patients should ask their providers about the COVID-19 vaccine is, “When can I get it?”

Be proactive in calling your provider to ask for the vaccine, says Gabbay. Check the websites of your state and local health departments to find out about local vaccine distribution. “Being patient, persistent, and informed is the best approach,” says Gabbay.

Source: Everyday Health