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Vaccination of patients with diabetes mellitus

https://doi.org/10.14341/DM12833

Abstract

Diabetes mellitus stays an important medical, economic and social problem worldwide. Infectious diseases in people with diabetes mellitus are often more severe with an increased frequency of hospitalizations and complications. The presence of chronic hyperglycemia leads to decreased immune function and an increased predisposition to infections. Infections lead to uncontrolled hyperglycemia, which worsens the course of infections, thus forming a vicious circle of violations.

Mass vaccination with an emphasis on people belonging to the high-risk group reduces the number of infected and, hospitalized people, and also has clear economic advantages. However, in many countries the proportion of vaccinated remains low.

Vaccine prophylaxis in Russia is regulated by a number of regulatory legal acts, of which the main one is Federal Law No. 157-FZ of September 17, 1998 (edited on July 2, 2021) «About Immunoprophylaxis of Infectious Diseases». Each country has a National Vaccination Schedule, which shows a routine vaccination schedule at a specific age against infections that are widespread and / or pose a serious threat to health and life), as well as a National Epidemic Indication Vaccination Schedule. In Russia, these documents are approved by Order of the Ministry of Health of the Russian Federation of March 21, 2014 N 125n «About the approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.»

This article discusses vaccination against the most socially significant infections associated with a high worldwide prevalence and increased risk among people with diabetes.

About the Authors

M. V. Shestakova
Endocrinology Research Centre
Russian Federation

Marina V. Shestakova - MD, PhD, Professor; eLibrary SPIN: 7584-7015

Moscow


Competing Interests:

none



T. V. Nikonova
Endocrinology Research Centre
Russian Federation

Tatiana V. Nikonova - MD, PhD; eLibrary SPIN: 8863-0201

11, Dm. Ul'yanova st., Moscow, 117036


Competing Interests:

none



V. O. Barysheva
Endocrinology Research Centre
Russian Federation

Valeriya O. Barysheva, MD, PhD. eLibrary SPIN: 9620-1989.

Moscow


Competing Interests:

none



N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation

Natalya G. Mokrysheva - MD, PhD, Professor; eLibrary SPIN: 5624-3875.

Moscow


Competing Interests:

none



References

1. Diabetesatlas.org [Internet]. 2022. IDF Diabetes Atlas. Tenth Edition [cited January 2022]. Available from: https://diabetesatlas.org/

2. Atreja A, Kalra S. Infections in diabetes. J Pak Med Assoc. 2015;65(9):1028-1030. doi: https://doi.org/10.1590/S0080-623420160000200011

3. Alcusky MJ, Pawasauskas J. Adherence to Guidelines for Hepatitis B, Pneumococcal, and Influenza Vaccination in Patients With Diabetes. Clin Diabetes. 2015;33(3):116-122. doi:10.2337/diaclin.33.3.116

4. Monteiro CN, Gianini RJ, Stopa SR, et al. Cobertura vacinal e utilização do SUS para vacinação contra gripe e pneumonia em adultos e idosos com diabetes autorreferida, no município de São Paulo, 2003, 2008 e 2015*. Epidemiol e Serviços Saúde. 2018;27(2). doi: https://doi.org/10.5123/S1679-49742018000200006

5. Villarroel MA, Vahratian A. Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015. NCHS Data Brief. 2016;265:1-8.

6. Wang Y, Cheng M, Wang S, et al. Vaccination coverage with the pneumococcal and influenza vaccine among persons with chronic diseases in Shanghai, China, 2017. BMC Public Health. 2020;20(1):359. doi: https://doi.org/10.1186/s12889-020-8388-3

7. Arrelias CCA, Bellissimo-Rodrigues F, Lima LCL et al. Hepatitis B vaccination coverage in patients with diabetes mellitus. Rev da Esc Enferm da USP. 2016;50(2):255-262. doi: https://doi.org/10.1590/S0080-623420160000200011

8. Geneev C, Mathew N, Jacob JJ. Vaccination Status, Knowledge, and Acceptance of Adult Vaccinations against Respiratory Illness among Patients with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(2):280-282. doi: https://doi.org/10.4103/ijem.IJEM_29_18

9. Prikaz Minzdrava Rossii ot 06.12.2021 N 1122n «Ob utverzhdenii natsional’nogo kalendarya profilakticheskikh privivok, kalendarya profilakticheskikh privivok po epidemicheskim pokazaniyam i poryadka provedeniya profilakticheskikh privivok» (In Russ.).

10. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol’nym sakharnym diabetom. Ed. by Dedov II, Shestakovа MV, Maiorov AYu. 10 vypusk (In Russ.). doi: https://doi.org/10.14341/DM12802

11. Diabetes Technology: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(S1):S85-S99. doi: https://doi.org/10.2337/dc21-S007

12. Butler SO, Btaiche IF, Alaniz C. Relationship between hyperglycemia and infection in critically ill patients. Pharmacotherapy. 2005;25(7):963-976. doi: https://doi.org/10.1592/phco.2005.25.7.963

13. Mad’ar R, Benesová D, Brandejská D, et al. Vaccination of patients with diabetes mellitus--a retrospective study. Cent Eur J Public Health. 2011;19(2):98-101. doi: https://doi.org/10.21101/cejph.a3634

14. Icardi G, Francia F, Di Bartolo P, et al. Multi-disciplinary Consensus Statement Document Vaccinal prevention in adult patients with diabetes mellitus. J Prev Med Hyg. 2018;59(4):E249-E256. doi: https://doi.org/10.15167/2421-4248/jpmh2018.59.4.1124

15. Kesavadev J, Misra A, Das AK, et al. Suggested use of vaccines in diabetes. Indian J Endocrinol Metab. 2012;16(6):886-893. doi: https://doi.org/10.4103/2230-8210.102982

16. Vremennye metodicheskie rekomendatsii «Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19)». Versiya 14 (27.12.2021) (In Russ.).

17. WHO — Prequalification of Medical Products (IVDs, Medicines, Vaccines and Immunization Devices, Vector Control). 2022. COVID-19 vaccines WHO EUL issued. [Internet] [cited 18 January 2022]. Available from: https://extranet.who.int/pqweb/vaccines/vaccinescovid-19-vaccine-eul-issued

18. Hamed E, Alnuaimi AS, Syed MA, et al. Clinical characteristics of 51,815 patients presenting with positive and negative SARS-CoV-2 swab results in primary health care settings: Priority populations for vaccination. J Infect. 2021;82(4):84-123. doi: https://doi.org/10.1016/j.jinf.2020.11.014

19. Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia — A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14(4):395-403. doi: https://doi.org/10.1016/j.dsx.2020.04.018

20. Leong DP, Banerjee A, Yusuf S. COVID-19 Vaccination Prioritization on the Basis of Cardiovascular Risk Factors and Number Needed to Vaccinate to Prevent Death. Can J Cardiol. 2021;37(7):1112-1116. doi: https://doi.org/10.1016/j.cjca.2021.04.012

21. McGovern AP, Thomas NJ, Vollmer SJ, et al. The disproportionate excess mortality risk of COVID-19 in younger people with diabetes warrants vaccination prioritisation. Diabetologia. 2021;64(5):1184-1186. doi: https://doi.org/10.1007/s00125-021-05404-8

22. Hassan-Smith Z, Hanif W, Khunti K. Who should be prioritised for COVID-19 vaccines? Lancet. 2020;396(10264):1732-1733. doi: https://doi.org/10.1016/S0140-6736(20)32224-8

23. Shestakova MV, Vikulova OK, Isakov MA, et al. Diabetes and COVID-19: analysis of the clinical outcomes according to the data of the Russian diabetes registry. Problems of Endocrinology. 2020;66(1):35-46. (In Russ.). doi: https://doi.org/10.14341/probl12458

24. Pal R, Sachdeva N, Mukherjee S, et al. Impaired anti-SARS-CoV-2 antibody response in non-severe COVID-19 patients with diabetes mellitus: A preliminary report. Diabetes Metab Syndr. 2021;15(1):193-196. doi: https://doi.org/10.1016/j.dsx.2020.12.035

25. Sakowicz-Burkiewicz M, Kocbuch K, Grden M, et al. High glucose concentration impairs ATP outflow and immunoglobulin production by human peripheral B lymphocytes: involvement of P2X7 receptor. Immunobiology. 2013;218(4):591-601. doi: https://doi.org/10.1016/j.imbio.2012.07.010

26. Pal R, Bhadada SK, Misra A. COVID-19 vaccination in patients with diabetes mellitus: Current concepts, uncertainties and challenges. Diabetes Metab Syndr Clin Res Rev. 2021;15(2):505-508. doi: https://doi.org/10.1016/j.dsx.2021.02.026

27. Lampasona V, Secchi M, Scavini M, et al. Antibody response to multiple antigens of SARS-CoV-2 in patients with diabetes: an observational cohort study. Diabetologia. 2020;63(12):2548-2558. doi: https://doi.org/10.1007/s00125-020-05284-4

28. Dispinseri S, Lampasona V, Secchi M, et al. Robust Neutralizing Antibodies to SARS-CoV-2 Develop and Persist in Subjects with Diabetes and COVID-19 Pneumonia. J. Clin. Endocrinol. Metab. 2021;106:1472-1481. doi: https://doi.org/10.1210/clinem/dgab055

29. Yelin I, Katz R, Herzel. E, et al. Associations of the BNT162b2 COVID-19 vaccine effectiveness with patient age and comorbidities. medRxiv. 2021. doi: https://doi.org/10.1101/2021.03.16.21253686

30. Ali H, Alterki A, Sindhu S, et al. Robust Antibody Levels in Both Diabetic and Non-Diabetic Individuals After BNT162b2 mRNA COVID-19 Vaccination. Front Immunol. 2021;12:752233. doi: https://doi.org/10.3389/fimmu.2021.752233

31. Sauré D, O’Ryan M, Torres JP, et al. Dynamic IgG seropositivity after rollout of CoronaVac and BNT162b2 COVID-19 vaccines in Chile: a sentinel surveillance study. Lancet Infect Dis. 2022;22(1):56-63. doi: https://doi.org/10.1016/S1473-3099(21)00479-5

32. Сhultz NH, Sorvoll IH, Michelsen AE, et al. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N. Engl. J. Med. 2021;384:2124-2130. doi: https://doi.org/10.1056/NEJMoa2104882

33. Powers A.C., Aronoff D.M., Eckel R.H. COVID-19 vaccine prioritisation for type 1 and type 2 diabetes. Lancet Diabetes Endocrinol. 2021;9:140-141. doi: https://doi.org/10.1016/S2213-8587(21)00017-6

34. U.S. Food and Drug Administration. [Internet] 2022. COVID-19 Vaccines [cited 18 January 2022]. Available at: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines

35. Shestakova MV, Vikulova OK*, Elfimova AR, et al. Risk factors for COVID-19 case fatality rate in people with Type1 and Type 2 diabetes mellitus: A Russian nationwide retrospective cohort study of 235 248 patients. PLOS ONE (in press).

36. Prikaz Minzdrava Rossii №8n ot 13.01.2022 «Ob utverzhdenii perechnja medicinskih protivopokazanij k provedeniju profilakticheskih privivok protiv novoj koronavirusnoj infekcii COVID-19». (In Russ.).

37. Pozicija FGBU «NMIC endokrinologii» Minzdrava Rossii o neobhodimosti vakcinacii bol’nyh saharnym diabetom protiv novoj koronavirusnoj infekcii FGBU «NMIC jendokrinologii» Minzdrava Rossii. (In Russ.) [cited 21 October 2021 (In Russ.)]. Available from: https://www.endocrincentr.ru/news/poziciya-fgbu-nmic-endokrinologii-minzdrava-rossii-o-neobhodimosti

38. Ese-hormones.org [Internet]. 2021. European Society of Endocrinology (ESE)’s statement concerning COVID-19 vaccination: ‘follow the same recommendations for patients with stable endocrine disorders as for the general population’. ESE. [cited 15 November 2021]. Available from: https://www.ese-hormones.org/news/ese-news/european-society-of-endocrinology-ese-s-statement-concerning-covid-19-vaccination-follow-the-same-recommendations-for-patients-with-stable-endocrine-disorders-as-for-the-general-population/

39. Puig-Domingo M, Marazuela M, Yildiz BO, Giustina A. COVID-19 and endocrine and metabolic diseases. An updated statement from the European Society of Endocrinology. Endocrine. 2021;72(2):301-316. doi: https://doi.org/10.1007/s12020-021-02734-w

40. Who.int [Internet] 2021. Influenza (Seasonal). [cited 21 October 2021] Available from: https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)

41. High-risk groups for Flu complications [Internet] 2021. [cited 21 October 2021]. Available from: https://www.marshfieldclinic.org/specialties/primary-care/flu/flu-high-risk

42. Who.int [Internet]. 2021. [cited 21 October 2021]. Available from: https://www.who.int/immunization/sage/meetings/2012/april/1_Background_Paper_Mar26_v13_cleaned.pdf

43. Immunoprofilaktika-2018:spravochnik, 13-e izdanie, rasshirennoe. Ed. by Tatochenko VK, Ozereckovskij NA. Moscow: Borges; 2018. 272 p. (In Russ.).

44. Mertz D, Kim TH, Johnstone J, et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ. 2013;347:f5061. doi: https://doi.org/10.1136/bmj.f5061

45. Sheridan PA, Paich HA, Handy J, et al. The antibody response to influenza vaccination is not impaired in type 2 diabetics. Vaccine. 2015;33(29):3306-3313. doi: https://doi.org/10.1016/j.vaccine.2015.05.043

46. Vamos EP, Pape UJ, Curcin V, et al. Effectiveness of the influenza vaccine in preventing admission to hospital and death in people with type 2 diabetes. CMAJ. 2016;188(14):E342-E351. doi: https://doi.org/10.1503/cmaj.151059

47. Wang IK, Lin CL, Chang YC, et al. Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study. Vaccine. 2013;31(4):718-724. doi: https://doi.org/10.1016/j.vaccine.2012.11.017

48. Bechini A, Ninci A, Del Riccio M, et al. Impact of Influenza Vaccination on All-Cause Mortality and Hospitalization for Pneumonia in Adults and the Elderly with Diabetes: A Meta-Analysis of Observational Studies. Vaccines (Basel). 2020;8(2):263. doi: https://doi.org/10.3390/vaccines8020263

49. Modin D, Claggett B, Køber L, et al. Influenza Vaccination Is Associated With Reduced Cardiovascular Mortality in Adults With Diabetes: A Nationwide Cohort Study. Diabetes Care. 2020;43(9):2226-2233. doi: https://doi.org/10.2337/dc20-0229

50. Dos Santos G, Tahrat H, Bekkat-Berkani R. Immunogenicity, safety, and effectiveness of seasonal influenza vaccination in patients with diabetes mellitus: A systematic review. Hum Vaccin Immunother. 2018;14(8):1853-1866. doi: https://doi.org/10.1080/21645515.2018.1446719

51. Seo YB, Baek JH, Lee J, et al. Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes. Clin Vaccine Immunol. 2015;22(11):1160-1165. doi: https://doi.org/10.1128/CVI.00288-15

52. Lau D, Eurich DT, Majumdar SR, et al. Effectiveness of influenza vaccination in working-age adults with diabetes: a population-based cohort study. Thorax. 2013;68(7):658-663. doi: https://doi.org/10.1136/thoraxjnl-2012-203109

53. McElhaney JE, Garneau H, Camous X, et al. Predictors of the antibody response to influenza vaccination in older adults with type 2 diabetes. BMJ Open Diabetes Res Care. 2015;3(1):e000140. doi: https://doi.org/10.1136/bmjdrc-2015-000140

54. GBD 2016 Lower Respiratory Infections Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018;18(11):1191-1210. doi: https://doi.org/10.1016/S1473-3099(18)30310-4

55. Said MA, Johnson HL, Nonyane BA, et al. Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques. PLoS One. 2013;8(4):e60273. doi: https://doi.org/10.1371/journal.pone.0060273

56. Вакцинопрофилактика пневмококковой инфекции. Федеральные клинические рекомендации. — М.; 2015. — 24 с. [Vakcinoprofilaktika pnevmokokkovoj infekcii. Federal’nye klinicheskie rekomendacii. Moscow; 2015. 24 p. (In Russ.)].

57. Torres A, Blasi F, Dartois N, et al. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease. Thorax. 2015;70(10):984-989. doi: https://doi.org/10.1136/thoraxjnl-2015-206780

58. Smith SA, Poland GA. Use of influenza and pneumococcal vaccines in people with diabetes. Diabetes Care. 2000;23(1):95-108. doi: https://doi.org/10.2337/diacare.23.1.95

59. Centers for Disease Control and Prevention (CDC). Advisory Committee on Immunization Practices. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

60. Matanock A, Lee G, Gierke R, et al. Use of 13-valent pneumoco.ccal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68:1069-1075. doi: https://doi.org/10.15585/mmwr.mm6846a5

61. Centers for Disease Control and Prevention (CDC). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61(40):816-819.

62. Diabeteseducator.org [Internet]. 2021. [cited 21 October 2021] Available from: https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/vaccination-practices-for-adults-with-diabetesv2.pdf?sfvrsn=2

63. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 741. Maternal immunization. Obstet Gynecol. 2018;131:e214-217.

64. Grabenstein JD, Weber DJ. Pneumococcal Serotype Diversity Among Adults in Various Countries, Influenced by Pediatric Pneumococcal Vaccination Uptake. Clin Infect Dis. 2014;58(6):854-864. doi: https://doi.org/10.1093/cid/cit800

65. Jackson LA, Gurtman A, van Cleeff M, et al. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine compared to a 23-valent pneumococcal polysaccharide vaccine in pneumococcal vaccine-naive adults. Vaccine. 2013;31(35):3577-3584. doi: https://doi.org/10.1016/j.vaccine.2013.04.085

66. Jackson LA, Gurtman A, Rice K, et al. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine in adults 70 years of age and older previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine. 2013;31(35):3585-3593. doi: https://doi.org/10.1016/j.vaccine.2013.05.010

67. Bonten MJ, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015;372(12):1114-1125. doi: https://doi.org/10.1056/NEJMoa1408544

68. Kuo CS, Lu CW, Chang YK, et al. Effectiveness of 23-valent pneumococcal polysaccharide vaccine on diabetic elderly. Medicine (Baltimore). 2016;95(26):e4064. doi: https://doi.org/10.1097/MD.0000000000004064

69. Butler JC. Pneumococcal Polysaccharide Vaccine Efficacy. JAMA. 1993;270(15):1826-1831. doi: https://doi.org/10.1001/jama.1993.03510150060030

70. Nguyen MH, Wong G, Gane E, et al. Hepatitis B Virus: Advances in Prevention, Diagnosis, and Therapy. Clin Microbiol Rev. 2020;33(2). doi: https://doi.org/10.1128/CMR.00046-19

71. Sonoki K, Yoshinari M, Iwase M, et al. Regurgitation of Blood into Insulin Cartridges in the Pen-like Injectors. Diabetes Care. 2001;24(3):603-604. doi: https://doi.org/10.2337/diacare.24.3.603

72. Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Reports. 2018;67(1):1-31. doi: https://doi.org/10.15585/mmwr.rr6701a1

73. Younossi Z, Kochems K, de Ridder M, et al. Should adults with diabetes mellitus be vaccinated against hepatitis B virus? A systematic review of diabetes mellitus and the progression of hepatitis B disease. Hum Vaccin Immunother. 2017;13(11):2695-2706. doi: https://doi.org/10.1080/21645515.2017.1353850

74. Cdc.gov [Internet]. 2021. Use of Hepatitis B Vaccination for Adults with Diabetes Mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP) [cited 21 October 2021]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a4.htm

75. Zanoni G, Contreas G, Valletta E, et al. Normal or defective immune response to Hepatitis B vaccine in patients with diabetes and celiac disease. Hum Vaccin Immunother. 2015;11(1):58-62. doi: https://doi.org/10.4161/hv.34309

76. Alavian SM, Tabatabaei SV. The effect of diabetes mellitus on immunological response to hepatitis B virus vaccine in individuals with chronic kidney disease: A meta-analysis of current literature. Vaccine. 2010;28(22):3773-3777. doi: https://doi.org/10.1016/j.vaccine.2010.03.038

77. Van Der Meeren O, Peterson JT, Dionne M, et al. Prospective clinical trial of hepatitis B vaccination in adults with and without type-2 diabetes mellitus. Hum Vaccin Immunother. 2016;12(8):2197-2203. doi: https://doi.org/10.1080/21645515.2016.1164362

78. Hyer RN, Janssen RS. Immunogenicity and safety of a 2-dose hepatitis B vaccine, HBsAg/CpG 1018, in persons with diabetes mellitus aged 60-70 years. Vaccine. 2019;37(39):5854-5861. doi: https://doi.org/10.1016/j.vaccine.2019.08.005

79. Karnchanasorn R, Ou H-Y, Lin J, et al. Viral Hepatitis and Diabetes: Clinical Implications of Diabetes Prevention Through Hepatitis Vaccination. Curr Diab Rep. 2016;16(10):101. doi: https://doi.org/10.1007/s11892-016-0790-y

80. Centers for Disease Control and Prevention [Internet]. 2021. CDC’s Vaccine Information for Adults with Diabetes [cited 21 October 2021]. Available from: https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/diabetes.html


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For citations:


Shestakova M.V., Nikonova T.V., Barysheva V.O., Mokrysheva N.G. Vaccination of patients with diabetes mellitus. Diabetes mellitus. 2022;25(1):50-60. (In Russ.) https://doi.org/10.14341/DM12833

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