Effectiveness and safety of COVID-19 vaccines in patients with diabetes as a factor for vaccine hesitancy

Abstract

Diabetes mellitus is one of the most common comorbid conditions encountered in patients with severe acute respiratory syndrome coronavirus 2 infection accompanied by significantly increased mortality, prolonged hospital stay, and requirement of invasive mechanical ventilation. This review aims to present the effectiveness and safety profile of available coronavirus disease 2019 (COVID-19) vaccines in people with diabetes as a potential cause of hesitancy for vaccination. Data from published research proves a robust immune response following immunization for COVID-19 in diabetic patients with substantial production of virus-neutralizing antibodies; however, the observed immune response was unequivocally weaker than that in individuals without diabetes. This observation was further enhanced by the findings that worse glycemic control was associated with more suppressed antibody production. In contrast, individuals with optimal glycemic control performed similarly to healthy controls. In addition to the need for strict glucose monitoring and adequate diabetes treatment, those findings reinforce the concept of diabetes-induced secondary immune deficiency and necessitate the application of booster doses to diabetic patients with priority. Nevertheless, after vaccination, reported adverse events were not different from those in the general population. No increase in severe adverse events was documented. While single case reports detected transient increases in blood glucose post-vaccination, more extensive trials could not replicate such a relationship.

Reported side-effects following Oxford/AstraZeneca COVID-19 vaccine in the north-west province, Iran: A cross-sectional study

“…On the other hand, any significant influence of cancer, receiving chemotherapy or having a comorbidity on the risk of developing adverse events after vaccination was rejected. [50,[57][58][59][60]. However, the reduced immune response to the vaccine in recipients with chronic respiratory disorder [61][62][63][64], chronic liver disease [65], hypertension [47,49], and cancer [50,66,67] were demonstrated in several studies [68,69].…”

Islet transplantation-immunological challenges and current perspectives

“…[ 36 ]. Moreover, patients with diabetes may have a comp romised immune system, leading to a more complicated course of infections, including coronavirus disease 2019[ 37 ]. Some of the immune defects described in patients with diabetes are decreased cellular response in vitro , low complement factor 4, diminished cytokine response after stimulation, reduced chemotaxis, phagocytosis, and killing of polymorphonuclear cells and macrophages[ 38 ].…”

The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes

“…The experience of immunization against Ebola in various African nations has demonstrated that social and political opposition can emerge when new vaccinations are deployed during public health emergencies [ 9 ]. Therefore, effective immunization programs must disseminate adequate safety information to counter doubts and conspiracy theories [ 10 ]. Various international publications report different prevalence rates of adult vaccine administration in diabetic patients.…”