People with Diabetes and Hepatitis B
Certain people with diabetes should be vaccinated against hepatitis B.
People with diabetes are at risk for hepatitis B because of frequent percutaneous exposures to blood. Therefore, CDC and the Advisory Committee for Immunization Practices (ACIP) recommends hepatitis B vaccination for all unvaccinated adults with diabetes who are younger than 60 years of age. For unvaccinated people with diabetes who are ≥60 years of age, ACIP recommends hepatitis B vaccination occur at the discretion of the health-care provider.
- Vaccination should occur as soon as possible after diagnosis of diabetes.
- Vaccination should also be given to adults diagnosed with diabetes in the past, who have not been previously vaccinated.
CDC also recommends one-time hepatitis C testing of all adults (18 years and older) and regular testing for people with risk factors.
People with Diabetes and Hepatitis B
CDC has investigated numerous hepatitis B outbreaks in people with diabetes in several settings, including long-term care facilities, hospitals, community health centers, ambulatory surgical centers, private offices, homes, and health fairs. Modes of transmission are believed to have occurred from:
- use of blood glucose meter for more than one resident without cleaning and disinfection between uses,
- failure to consistently wear gloves and perform hand hygiene between fingerstick procedures,
- use of the same fingerstick devices for more than one resident,
- cross-contamination of clean supplies with contaminated blood glucose monitoring equipment used by home health agencies,
- use of the same injection equipment such as a syringe or insulin pen for more than one person,
- failure to maintain separation of clean and contaminated podiatry equipment,
- improper sterilization of contaminated podiatry equipment, and
- failure to perform environmental cleaning and disinfection between podiatry patients.
Scientific Guidelines and Recommendations
Use of Hepatitis B Vaccination for Adults with Diabetes Mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR 2011;60(50);1709-1711.
CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020. MMWR 2020; 69(2);1–17.
Resources
Fact Sheet: Diabetes and Hepatitis B Vaccination – Information for Diabetes Educators pdf icon[PDF – 2 pages]
Fact Sheet: Hepatitis B – General Information pdf icon[PDF – 281 KB]