What vaccines do people with diabetes need? The American Diabetes Association (ADA) lists seven: flu, COVID-19, pneumococcal (pneumonia), respiratory syncytial virus (RSV), hepatitis B, tetanus-diphtheria-pertussis (Tdap), and shingles. Which ones apply to you depends on your age and your vaccine history. The Centers for Disease Control and Prevention (CDC) says people with diabetes, both type 1 and type 2, are at higher risk for serious problems, including hospitalization or death, from certain vaccine-preventable diseases.
Key takeaways
- ADA lists flu every year, pneumococcal for adults 19 and older, RSV for adults 60 and older, hepatitis B for adults 59 and younger, Tdap every 10 years, and shingles from age 50.
- ADA words the COVID-19 vaccine as a decision you make with your doctor or pharmacist.
- CDC lists diabetes as a risk condition for pneumococcal vaccination, and says all adults 50 and older should get it.
- People with diabetes should get the injected flu shot, not the live nasal spray.
- Recommendations change, and different pages are updated at different times. Ask your doctor or pharmacist what is current for you.
Why Vaccines Matter More With Diabetes
CDC's adult vaccine fact sheet for people with diabetes (March 2020) says diabetes, even if well managed, can make it harder for your immune system to fight infections. It also says illnesses like influenza can raise your blood sugar to dangerously high levels. ADA adds that high blood glucose can make it harder for the body to fight infections.
CDC's fact sheet gives two more reasons:
- Hepatitis B. CDC says people with diabetes have higher rates of hepatitis B than the rest of the population. CDC also says outbreaks have been linked to blood glucose monitoring equipment such as meters, finger stick devices, and insulin pens.
- Serious infections. CDC says people with diabetes are at increased risk of death from pneumonia (a lung infection), bacteremia (a blood infection), and meningitis (an infection of the lining of the brain and spinal cord).
CDC says vaccines are one of the safest ways to protect your health, even if you take prescription medicines for diabetes. For the bigger picture on infections, see our guide to whether diabetes weakens your immune system.
The Vaccines at a Glance
This table follows ADA's current patient page on vaccinations. Ask your doctor or pharmacist how it applies to you.
| Vaccine | Who ADA lists it for | How often (ADA) |
|---|---|---|
| Flu (influenza) | Everyone with diabetes | Every year, September to October |
| COVID-19 | Ages 6 months and older, if you and your healthcare team decide it is right for you | Every year |
| Pneumococcal (pneumonia) | Adults 19 and older | Varies with the type of vaccine used |
| RSV | Adults 60 and older | Once |
| Hepatitis B | 59 and younger; talk with your team if 60 and older | Varies with the type of vaccine used |
| Tdap (tetanus, diphtheria, whooping cough) | Adults 18 and older | Every 10 years and during each pregnancy |
| Shingles (zoster) | 50 and older | Two doses |
ADA's Standards of Care in Diabetes—2026 ask clinicians to provide routinely recommended vaccinations for adults with diabetes by age, and list vaccination history and needs as part of the comprehensive medical evaluation. The Standards table is worded a little differently in places, which the sections below point out.
Flu Vaccine
ADA says that in general, every person with diabetes needs a flu shot each year, and that September or October is the best time. ADA says the shot takes about two weeks to work and does not give 100% protection, but it makes catching the flu less likely for about six months and lowers the risk of hospitalization or other complications.
ADA says people with diabetes should not get the live flu vaccine, which is given as a nasal spray. CDC agrees: it says people with diabetes should get the injectable flu vaccine and generally not the nasal spray. Read more in our guide on whether diabetics should get a flu shot.
Pneumococcal Vaccine
Pneumococcal disease is a bacterial infection that can cause pneumonia, meningitis, and bloodstream infections. CDC recommends pneumococcal vaccination for all adults 50 and older, and for adults 19 through 49 with certain risk conditions. CDC's risk-condition list for adults includes diabetes mellitus.
Which pneumococcal vaccine you get depends on your age and the vaccines you have already had. ADA says that when more than one type is recommended, the doses are usually about a year apart. CDC's patient page says to talk to a vaccine provider about your history.
One thing to watch: CDC's older page on the immune system and diabetes (May 2024) lists adults 65 and older and adults 19 to 64 with conditions such as diabetes. CDC's pneumococcal pages, updated in 2026, list adults 50 and older. That change is a good example of why you should ask for current guidance. Our guide on the pneumonia vaccine for people with diabetes goes into more detail.
COVID-19 Vaccine
ADA says COVID-19 can be more serious for people with diabetes and can raise the risk of hospitalization and death. ADA says the vaccine is important for people 6 months and older with risk factors like diabetes. It also says one dose per year is recommended for most people, that certain groups may get more than one, and that you should decide with your doctor or pharmacist whether you need it and how many doses.
COVID-19 guidance has changed several times. CDC's immune system and diabetes page (May 2024) says the vaccine is recommended for everyone, while ADA's current wording stresses a shared decision. Ask your care team for the guidance that applies to you now.
RSV Vaccine
ADA says that if you have diabetes, you are more likely to get RSV and to have serious problems from it. ADA says this may happen because diabetes weakens the immune system so it cannot fight germs as well. RSV can lead to pneumonia and bronchiolitis.
ADA's patient page says adults 60 and older can receive a single dose and that CDC recommends getting it in late summer or early fall. ADA's Standards table is worded more narrowly: adults 75 and older, and adults 60 and older at high risk, may receive a single dose, and older adults with diabetes appear to be a risk group. If you are 60 or older, ask your clinician whether you qualify.
Hepatitis B Vaccine
ADA lists hepatitis B vaccine for adults with diabetes 59 and younger, and says to talk with your healthcare team if you are 60 or older. CDC's hepatitis B page (updated September 2025) recommends it for adults 19 through 59, and for adults 60 and older with risk factors for hepatitis B.
ADA describes a series of 2 to 4 doses, and CDC says two or three shots depending on the brand. Your provider will tell you which series you are getting.
Because CDC links hepatitis B outbreaks to shared blood glucose monitoring equipment, never share a meter, lancing device, or insulin pen with anyone. Our guide on what diabetes tests you need each year shows where vaccines fit into your routine care.
Tdap and Shingles Vaccines
Tdap protects against tetanus, diphtheria, and whooping cough. ADA lists it for adults 18 and older every 10 years, and during each pregnancy.
Shingles. CDC recommends the two-dose shingles vaccine (Shingrix) for adults 50 and older, with the doses separated by 2 to 6 months. CDC says to get it even if you have had shingles, chickenpox, or the chickenpox vaccine. CDC says about 1 in 3 people in the United States will have shingles in their lifetime, and that the vaccine also protects against postherpetic neuralgia, long-term nerve pain that can last months or years. CDC says the shingles vaccine may be given at the same time as other vaccines.
How to Get Your Vaccines and What They Cost
CDC says adults can get vaccines at doctors' offices, pharmacies, workplaces, community health clinics, and health departments. CDC suggests starting with the provider who sees you for diabetes care, and asking for a referral if they do not offer the vaccine you need.
On cost, ADA says Medicare may cover vaccines under Part B in the doctor's office, Part D at the pharmacy, or both, and most private insurance programs cover vaccines at low or no cost. CDC's fact sheet says most health insurance plans cover recommended vaccines. Check with your insurer.
Everyday Steps That Help Too
Vaccines are one layer. ADA also lists basic steps to prevent person-to-person spread:
- Cover your cough or sneeze with a tissue or your elbow.
- Wash your hands often with soap and water, or use an alcohol-based hand cleaner.
- Avoid touching your eyes, nose, and mouth.
- Stay away from sick people when you can, and stay home if you are sick.
ADA also recommends planning ahead for sick days. Our guide to diabetes sick day rules covers what to keep on hand and when to call for help.
Questions to Ask Your Care Team
- Which of these vaccines have I had, and which am I due for?
- Which pneumococcal vaccine is right for me, and when should I get the next dose?
- Is the COVID-19 vaccine right for me this year?
- Do my age, medicines, or other health conditions change anything?
- Where can I get each one, and how is it covered?
Bring any vaccine records you have. Your pharmacy or state immunization registry may be able to help you find them.
When to Call Your Care Team
Call 911 for trouble breathing, swelling of the face or throat, or fainting after a vaccine.
Call the same day for a fever, a cough that is getting worse, or blood sugar readings that stay well above your targets. After a shingles shot, CDC says to contact your provider if side effects are not improving or are getting worse.
At your next visit, ask about your vaccine history and what you are due for.
Frequently Asked Questions
What vaccines should a person with diabetes get?
ADA lists the flu vaccine every year, the pneumococcal vaccine for adults 19 and older, the RSV vaccine for adults 60 and older, the hepatitis B vaccine for adults 59 and younger, the Tdap vaccine every 10 years, and the shingles vaccine from age 50. ADA says the COVID-19 vaccine is a decision to make with your care team. Ask your doctor or pharmacist what is current for you.
Do people with type 2 diabetes need the pneumonia vaccine?
CDC recommends pneumococcal vaccination for all adults 50 and older, and for adults 19 through 49 with certain risk conditions. CDC lists diabetes mellitus among those risk conditions. ADA lists it for adults 19 and older with diabetes. Which vaccine you get and when depends on your age and past doses.
Is the flu shot safe for people with diabetes?
CDC says vaccines are one of the safest ways to protect your health, even if you take prescription medicines for diabetes. ADA says people with diabetes should get the injected flu shot and not the live nasal spray. If you have had a reaction to a flu shot, tell the person giving it before you get another.
Can I get more than one vaccine at the same visit?
CDC says the shingles vaccine may be given at the same time as other vaccines. For other combinations, and for the timing of pneumococcal doses, ask your provider or pharmacist, who can check your records and the current schedule.
Are vaccines covered by insurance?
ADA says Medicare may cover vaccines under Part B, Part D, or both, and most private insurance programs cover vaccines at low or no cost. CDC says most health insurance plans cover recommended vaccines. Ask your insurer or pharmacy about your plan.
Should I get the COVID-19 vaccine if I have diabetes?
ADA says COVID-19 can be more serious for people with diabetes and that the vaccine is important for people 6 months and older with risk factors like diabetes. ADA also says the decision about whether you need it, and how many doses, should be made with your doctor or pharmacist.
References
- American Diabetes Association. “Vaccinations.” Accessed October 2026.
- American Diabetes Association Professional Practice Committee for Diabetes. “4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2026.” Diabetes Care. 2026;49(Suppl. 1):S61–S88. Accessed October 2026.
- Centers for Disease Control and Prevention. “Diabetes and Adult Vaccines.” Fact sheet, March 2020. Accessed October 2026.
- Centers for Disease Control and Prevention. “Pneumococcal Vaccination.” Accessed October 2026.
- Centers for Disease Control and Prevention. “Summary of Risk-based Pneumococcal Vaccination Recommendations.” Accessed October 2026.
- Centers for Disease Control and Prevention. “Hepatitis B Vaccine.” Accessed October 2026.
- Centers for Disease Control and Prevention. “Shingles Vaccination.” Accessed October 2026.
- Centers for Disease Control and Prevention. “Your Immune System and Diabetes.” Accessed October 2026.
- Centers for Disease Control and Prevention. “Flu and People with Diabetes.” Accessed October 2026.
Next Steps
Ask your doctor or pharmacist to look up your vaccine record, and write down which vaccines you are due for. Then read the spokes on flu shots and the pneumonia vaccine.
For adults with type 2 diabetes or prediabetes who want lifestyle education alongside clinical care, the Done With Diabetes™ program, a holistic approach to type 2 diabetes, organizes learning about meals, movement, sleep, and stress. It does not diagnose or treat diabetes or infections, advise on vaccines, interpret test results, change medicines, or replace your care team.