Have These Patients Been Immunized Appropriately?

A Case-Based Challenge

Robert H. Hopkins, Jr., MD


August 06, 2014

Hepatitis B Vaccination Recommendations

Hepatitis B vaccine is recommended for all adults under the age of 60 years who have diabetes. Vaccination of patients with diabetes who are older than 60 years is at the clinician's discretion and should be based on both the patient's likelihood of acquiring hepatitis B infection and the patient's ability to mount an adequate immune response to the vaccine. Hepatitis B vaccine should be administered as a 3-dose series. Hepatitis B virus is also recommended in the large segment of the adult population that has additional risk factors for this viral infection. Complete guidance can be found on the Centers for Disease Control and Prevention (CDC) Website.

Case #3: Risk for Severe Influenza

Mr. Smith is a 52-year-old man with well-controlled diabetes. He received his initial hepatitis B, Tdap, and pneumococcal vaccines as recommended at his June clinic visit and has kept follow-up visits for additional care. He returns again in October, and your office staff recommend that he receive an influenza vaccine prior to his seeing you in the office. He replies to the nurse that he is really very healthy, has never had influenza, and does not need the vaccine.


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