People with Diabetes and Hepatitis B

doctor with seated elderly man

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.


Fact Sheet: Diabetes and Hepatitis B Vaccination – Information for Diabetes Educators [PDF – 2 pages]

Fact Sheet: Hepatitis B – General Information [PDF – 281 KB]

CDC’s Division of Diabetes Prevention and Control