Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Fort Worth, TX, USA.
University of the Incarnate Word Feik School of Pharmacy, San Antonio, TX, USA.
Ann Pharmacother. 2023 Jan;57(1):51-54. doi: 10.1177/10600280221098101. Epub 2022 Jun 2.
There are more than 350 reports of hyperglycemia post-influenza vaccine according to the Vaccine Adverse Effect Reporting System. Only one case report has been published detailing unusual post-vaccination hyperglycemia. The mechanism as to why hyperglycemia may occur post-vaccination has not been fully elucidated.
Primary: To identify hyperglycemia within the first 24 hours of influenza vaccine. Secondary: To identify transient property of hyperglycemia within 4 days after vaccine.
Multicenter prospective cohort study. Recruitment conducted throughout San Antonio, Texas, during 2018-2020 influenza seasons. Patients were included if 18 years or older, had diabetes mellitus, and currently checking their blood glucose daily. Patients excluded if they had a recent medication change that would effect their blood glucose readings. Patients had hemoglobin A1c and blood glucose measured prior to vaccination with a single dose (0.5 mL) of the tri-valent influenza vaccine intramuscularly. Glucose readings were collected within 24 hours post-vaccination and subsequent mornings for 4 days.
A total of 34 patients were included. Average patient age was 75 years with 60% white, 30% black, and 10% Hispanic. Median fasting glucose pre-vaccination was significantly lower than the median value 0 to 24 hours post-vaccination (140 vs 203 mg/dL, < 0.0001).
Hyperglycemia was noted 0 to 24 hours post-vaccination and was transient in nature with a return to baseline by post-vaccination day 2. This trial was conducted to close a potential gap in counseling regarding the flu vaccine and decrease any potential concern surrounding the vaccine in patients with diabetes that could lead to reduced vaccination rates.
根据疫苗不良反应报告系统，有超过 350 份关于流感疫苗接种后出现高血糖的报告。仅有一份病例报告详细描述了异常的疫苗接种后高血糖。高血糖为何可能在疫苗接种后发生的机制尚未完全阐明。
主要目的：在流感疫苗接种后 24 小时内识别高血糖。次要目的：在接种疫苗后 4 天内识别高血糖的短暂性。
多中心前瞻性队列研究。在 2018 年至 2020 年的流感季节，在德克萨斯州圣安东尼奥市进行了招募。纳入标准为年龄在 18 岁或以上、患有糖尿病且目前每天监测血糖的患者。排除标准为最近药物变化会影响血糖读数的患者。患者在接种三价流感疫苗（0.5 毫升，肌肉注射）前测量糖化血红蛋白和血糖。接种疫苗后 24 小时内和随后的 4 天内每天早上收集血糖读数。
共纳入 34 名患者。患者平均年龄为 75 岁，其中 60%为白人，30%为黑人，10%为西班牙裔。接种疫苗前空腹血糖中位数明显低于接种疫苗后 0 至 24 小时中位数（140 与 203mg/dL，<0.0001）。
接种疫苗后 0 至 24 小时内出现高血糖，且具有短暂性，接种疫苗后第 2 天恢复至基线。本试验旨在消除关于流感疫苗接种的咨询中的潜在差距，并减少糖尿病患者对疫苗的任何潜在担忧，从而降低疫苗接种率。
