Prioritization of COVID-19 vaccine for type 1 and type 2 diabetes

With the availability of the SARS-CoV-2 / COVID-19 vaccine, an important issue is the prioritization of groups of individuals who will receive the vaccine, which has been in limited supply for some time.1Rubin EJ Baden LR Barocas JA Morrissey S Audio Interview: SARS-CoV-2 Vaccination and Vulnerable Population. Several clinical reports describe the greater prevalence and mortality of COVID-19 in diabetic patients, often with obesity. Most of this information comes from individuals with type 2 diabetes, and little is known about the risk of type 1 diabetes, a phenotypic disorder. Experts warn against extrapolating from type 2 diabetes studies to individuals with type 1 diabetes.2Dimeglio LA Albanian-O'Neill A Munoz CE Mars DM COVID-19 and Children with Diabetes — What's New, Unknown, and Next Steps: First, don't extrapolate. In the United States, the Centers for Disease Control and Prevention (CDC) currently classifies type 1 and type 2 diabetes differently in terms of risk of severe illness than COVID-19, and people with type 2 diabetes are "severe." Is considered to be at high risk of illness. Patients with type 1 diabetes who are classified as "potentially at high risk".3Douring K Marine M Wallace M et al.Updated Interim Recommendations of the Immunization Implementation Advisory Board on the Allocation of COVID-19 Vaccines-US, December 2020.Importantly, some recent researchFourBaron E Bakai C Kar P et al.Association of Type 1 and Type 2 Diabetes and COVID-19-Related Mortality in the United Kingdom: All Census., FiveGregory JM Massacre JC Daphs SH et al.The severity of COVID-19 triples in the diabetic community: a prospective analysis of the effects of a pandemic on type 1 and type 2 diabetes., 6McGarnagan SJ Weir A Bishop J et al.Risks and Risk Factors for COVID-19 Disease in Diabetics: A Cohort Study of the Total Population of Scotland. Both people with type 2 diabetes and people with type 1 diabetes have been shown to be more vulnerable to serious illness with SARS-CoV-2 than those without diabetes. Relatively speaking, patients with type 1 diabetes and patients with type 2 diabetes had similar adjusted odds ratios (OR) for hospitalization (3.90 for type 1 diabetes). vs 3.36) for type 2 diabetes,FiveGregory JM Massacre JC Daphs SH et al.The severity of COVID-19 triples in the diabetic community: a prospective analysis of the effects of a pandemic on type 1 and type 2 diabetes. Disease severity (3.35) vs 3.42),FiveGregory JM Massacre JC Daphs SH et al.The severity of COVID-19 triples in the diabetic community: a prospective analysis of the effects of a pandemic on type 1 and type 2 diabetes. And in-hospital mortality (3.51 vs 2.02).FourBaron E Bakai C Kar P et al.Association of Type 1 and Type 2 Diabetes and COVID-19-Related Mortality in the United Kingdom: All Census. In a population-based study in Scotland, the risk of COVID-19 treated with fatal or critical care units was increased in both types of diabetes (or 2.4 in the case of type 1 diabetes). vs Type 2 diabetes 1.4).6McGarnagan SJ Weir A Bishop J et al.Risks and Risk Factors for COVID-19 Disease in Diabetics: A Cohort Study of the Total Population of Scotland.These findings are immediate from the CDC and other risk assessments, as risk classification and recommendations by the CDC and other healthcare policy makers influence state and healthcare decisions related to vaccine prioritization. The same high-risk category for individuals with either form of diabetes, prompting revisions. These changes in risk classification put more than one million people with type 1 diabetes in the United States into the same priority categories as people with type 2 diabetes and other high-risk conditions. We call on public health authorities and governors across the United States and relevant policy makers in other countries to carefully consider this new information as vaccine prioritization recommendations are made. ..RHE was the 2020 President of Medicine and Science at the American Diabetes Association. He declares personal rates from Novo Nordisk, Provenation Bio, and Kaleido. Other authors have not declared competing interests.References1.1.Rubin EJ Baden LR Barocas JA Morrissey S Audio Interview: SARS-CoV-2 Vaccination and Vulnerable Population.New Engl J Med. 2020; 383: e1432.2.Dimeglio LA Albanian-O'Neill A Munoz CE Mars DM COVID-19 and Children with Diabetes — What's New, Unknown, and Next Steps: First, don't extrapolate.Diabetes treatment. 2020; 43: 2631-26343.3.Douring K Marine M Wallace M et al.Updated Interim Recommendations of the Immunization Implementation Advisory Board on the Allocation of COVID-19 Vaccines-US, December 2020.MMWR Morb Mortal Wkly Rep. 2021; 69: 1657-16604.4.Baron E Bakai C Kar P et al.Association of Type 1 and Type 2 Diabetes and COVID-19-Related Mortality in the United Kingdom: All Census.Lancet Diabetes Endocrinol. 2020; 8: 813-8225.5.Gregory JM Massacre JC Daphs SH et al.The severity of COVID-19 triples in the diabetic community: a prospective analysis of the effects of a pandemic on type 1 and type 2 diabetes.Diabetes treatment. 2020; ()6.6.McGarnagan SJ Weir A Bishop J et al.Risks and Risk Factors for COVID-19 Disease in Diabetics: A Cohort Study of the Total Population of Scotland.Lancet Diabetes Endocrinol. 2020; ()Article informationPublication historyRelease date: January 18, 2021identificationDOI: https://doi.org/10.1016/S2213-8587 (21) 0107-6Copyright© 2021 Elsevier Ltd. 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Prioritization of COVID-19 vaccine for type 1 and type 2 diabetes

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Prioritization of COVID-19 vaccine for type 1 and type 2 diabetes

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