糖尿病患者必须了解的7件事有关COVID-19疫苗
The news around vaccines and booster shots for COVID-19 is ever-changing. Here’s the latest information that people living with type 1 and type 2 diabetes need to know about the potential lifesaving shots.
If you’re living with diabetes, you may have questions about the COVID-19 vaccine if you haven’t yet been inoculated. Or maybe you’ve already gotten the jab: So far, nearly 200 million Americans are fully vaccinated against COVID-19, including many with diabetes,according to the Centers for Disease Control and Prevention (CDC)。一个nd yet if you fall into the latter group, you may be curious to know whether you qualify or would benefit from a booster shot, a subject you’ve likely seen in the news recently.
长话短说：这对有类型1或者2型糖尿病to receivevaccinations for COVID-19because they are at increased risk for severe illness and death from the novel coronavirus,注意CDC。专家说，这些疫苗对这些人是安全有效的。
当前可用的COVID-19助推器也是如此。“您应该优先考虑健康，并花点时间获得助推器，”Robert Gabbay, MD, PhD美国的科学和医学总监an Diabetes Association (ADA) in Arlington, Virginia. “The U.S. Food and Drug Administration (FDA) has reviewed an incredible amount of information to decide on the safety and prioritization of booster vaccinations.”
Here’s an overview of what else you need to know about the COVID-19 vaccines — and those boosters you’ve been hearing about — if you have diabetes.
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1.目前有哪些COVID-19-19-19疫苗可供选择？
Three COVID-19 vaccines are currently available in the United States:
- Pfizer-BioNTech, available to people 12 years and older
- Moderna, available to people 18 years and older
- Johnson & Johnson’s Janssen, available to people 18 years and older
辉瑞（Pfizer-Biontech）和现代疫苗需要两次射击，并在第二次射击两周后提供全面疫苗接种。Johnson＆Johnson的Janssen疫苗需要一枪，并在射击两周后提供全疫苗接种。
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2. Are People With Diabetes Eligible for a COVID-19 Booster?
Gabbay博士说：“患有糖尿病患者的联盟并发症的风险更高，因此是基于FDA批准的疫苗助推器的优先人士。”截至10月20日，至少在六个月前，接收辉瑞-biontech疫苗或现代疫苗的人可以使用Covid-19-19疫苗助推器。根据FDA。People who got the Johnson & Johnson vaccine are also eligible to receive that vaccine’s booster at least two months after receiving the single dose. People who received one type of vaccine may receive a different type of booster — that is, people may “mix and match” vaccines, the FDA says.
The CDC says these groups should get a booster:
- Seniors ages 65 and older
- 生活在长期护理环境中的18岁以上的人
The CDC says these groups may get a booster:
- 18岁及以上的人患有潜在的医疗状况，包括1型或2型糖尿病，根据他们的个人利益和风险
- 18岁或以上的人在高风险环境中生活或工作，例如无家可归者庇护所，杂货店，医疗保健设施或学校
- 其他人，具体取决于医生对他们的福利和风险的评估
一个fter the CDC’s recommendations, each individual state rolls out its booster program.
Boosters are important because studies have shown that vaccine protection against SARS-2 coronavirus can decrease over time and be less protective against the delta variant,根据CDC网站。
3.患有糖尿病的人应该向他们的提供者询问助推器？
If you have questions about whether you should get a booster, talk to your healthcare provider, along with reading the CDC website for the most current updates for patients on boosters.
一个healthcare provider can guide you on the timing of the booster and how to treat any of the mild side effects that may occur after vaccination, says Gabbay.
Gabbay says a person with diabetes should consider asking these questions, which are edited for brevity:
- 我将从助推器那里获得多少额外的保护，这足以超过我可能遇到的负面影响？
- 考虑到六个月后的第一个来临，您希望我会收到多少个助推器？对于免疫系统受损的人来说，助推器是否更有可能？
- If I decide not to get a booster, what are my risks?
- 对于糖尿病患者的助推器是否有特定的担忧？
- 糖尿病会如何影响疫苗随着时间的流逝，对于那些可能选择或可能不会获得助推器的人会影响疫苗的功效？
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4。糖尿病患者的Covid-19-19疫苗是否无疫苗？
包括助推器在内的Covid-19疫苗对每个人都免费，无论糖尿病状态如何根据疾病预防控制中心。但是，一些管理疫苗的提供者可能会收取费用，如果您没有保险，则可以由您的公共或私人健康保险偿还费用，也可以由健康资源和服务管理局的提供者救济基金收取费用。
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 Gabbay.
在大流行中，CDC的一项研究，于2020年7月在发病率和死亡率每周报告, found that roughly half of people who died from COVID-19 under age 65 had diabetes.
英国的两项研究显示出类似的风险。一个study published in October 2020 inThe Lancet糖尿病和内分泌学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 astudy published in December 2020 inThe Lancet Diabetes & Endocrinology发现患有1型或2型的人更有可能在Covid-19的重症监护室中死亡或接受治疗。
最近，在study published in September 2021 in糖尿病护理, researchers analyzed data from 18 months into the pandemic, and found that 30 to 40 percent of people who died or experienced severe outcomes from COVID-19 had type 1 or type 2 diabetes. Once hospitalized, a quarter of all patients with diabetes are likely to die, the researchers concluded.
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贾斯汀·格雷戈里（Justin Gregory），医学博士, assistant professor of pediatrics at Vanderbilt Children’s Hospital in Nashville, Tennessee, who has1型糖尿病。
Hisstudy published in December 2020 in糖尿病护理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.
黑人，拉丁裔和美洲原住民的疫苗接种至关重要，因为这些社区受糖尿病和COVID-19的影响不成比例。非裔美国人和拉丁裔美国人患糖尿病的可能性超过50％according to the ADA。Black, Latino, and Native Americans experienced a death rate from COVID-19 double or more than white Americans in 2020,根据疾病预防控制中心。
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6.疫苗对糖尿病患者安全有效吗？
People with diabetes were included in the trials of all three vaccine currently available in the United States. And they are part of studies evaluating the real-world safety and effectiveness of the vaccines.
The Pfizer-BioNTech vaccine2021年8月获得FDA的全面批准for people 16 and older. It was also the first to receive紧急使用授权从2020年12月的FDA开始，紧急使用授权继续为12至15岁的人们继续使用。现代疫苗于2020年12月获得了18岁及以上的人的紧急使用授权。
对5,000名医护人员的研究于2021年9月出版The New England Journal of Medicine (NEJM)found that the Pfizer and Moderna vaccines were, respectively, 88.8 percent and 96.3 percent effective at preventing infection with symptoms.
“我们的study showed that complete vaccination with mRNA vaccines was effective in adults with more than one risk factor for severe COVID-19; in adults with obesity,hypertension，哮喘或糖尿病；在50岁以上的成年人中，这项研究的作者写道。
The one-doseJohnson & Johnson vaccineis 66 percent effective at preventing moderate to severeCovid-19疾病28 days after vaccination in clinical trials around the world; in U.S. trials it was 72 percent effective,根据第三阶段临床试验。在J＆J临床试验期间，在接种疫苗的人中，Covid-19的死亡或住院没有死亡或住院。它于2021年2月27日获得了FDA的紧急使用授权。
Buddy Creech, MD, MPH, is director of the Vanderbilt Vaccine Research Program in Nashville, Tennessee, was part of the phase 3 trials of theModerna Covid-19疫苗。“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.
1型，类型2和gestational diabetesparticipated in theModerna clinical trial，他补充说。辉瑞-biontech提交的FDA文件该审判说包括糖尿病患者，但没有在类型之间指定。和FDA备案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 does 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?
通常，最多常见的副作用两种疫苗都在注射部位疼痛，肿胀和发红。其他常见的副作用是寒意，疲倦和头痛。这些副作用大多数是温和的，但是有些人会产生更严重的反应，干扰了日常活动。
现代和辉瑞疫苗都带有警告标签，以增加心脏发炎的风险myocarditis。在分析于2021年9月发布NEJMresearchers reported the Pfizer vaccine had a rare, but increased risk for myocarditis. This is more common in young men, according to two studies published in October 6, 2021, inNEJM。However, infection with COVID-19 carries an even greater risk of myocarditis.
Gabbay说，COVID-19疫苗的副作用与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 after inoculation.
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Learn more about the rollout of COVID-19 vaccines for people with type 1 and type 2 in Diabetes Daily's article糖尿病患者的Covid-19疫苗：发生了什么？
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