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Review
. 2022 Dec 22;11(1):24.
doi: 10.3390/vaccines11010024.

Effectiveness of COVID-19 Vaccines in Adults with Diabetes Mellitus: A Systematic Review

Jesse M van den Berg  1   2   3 , Sharon Remmelzwaal  1   2   4 , Marieke T Blom  1   2 , Beryl A C E van Hoek  1   2 , Karin M A Swart  1   2   3 , Jetty A Overbeek  1   2   3 , George L Burchell  5 , Ron M C Herings  2   3   4 , Petra J M Elders  1   2
Affiliations
Review

Effectiveness of COVID-19 Vaccines in Adults with Diabetes Mellitus: A Systematic Review

Jesse M van den Berg et al. Vaccines (Basel). .

Abstract

Persons with diabetes mellitus may have an increased risk of severe illness or death from COVID-19 compared to persons without diabetes. Prior studies indicate that immune response and thus vaccine effectiveness might be lower in persons with diabetes. We aimed to systematically review the effectiveness of COVID-19 vaccines in adults with diabetes. Pubmed, Embase, Web of Science and Cochrane Library were searched for studies that evaluated the effectiveness of COVID-19 vaccines in adults with diabetes, published before 4 March 2022. Risk of bias in the included studies was evaluated using the ROBINS-I tool. At least two reviewers conducted the study selection, data extraction, and risk of bias assessment independently. After screening of 2196 studies, a total of 17 articles were included. Six different COVID-19 vaccines (Ad5-nCoV-S, AZD1222, BNT162b2, CoronaVac, JNJ-78436735, and mRNA-1273) were included in the synthesis. Vaccine effectiveness was reported for SARS-CoV-2 infection, symptomatic COVID-19, hospitalization, and death, and ranged from 24 to 96% in persons with diabetes, and from 33 to 97% in total study populations; effectiveness was generally lower for persons with diabetes. Odds ratios for breakthrough infection or severe COVID-19 ranged from 1.03 to 2.41 in vaccinated persons with diabetes compared to persons without diabetes. Even though the included studies were very heterogeneous, results from the synthesis indicate that effectiveness of COVID-19 vaccines might be lower in persons with diabetes. More research is needed on the comparison of vaccine effectiveness between persons with and without diabetes, and the effectiveness of repeat COVID-19 vaccinations.

Keywords: COVID-19; SARS-CoV-2; coronavirus; diabetes; systematic review; vaccination; vaccine effectiveness.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of inclusion of studies.
Figure 2
Figure 2
Forest plots with point estimates and 95% confidence intervals of effectiveness of COVID-19 vaccines against (A) infection, (B) symptomatic illness, (C) hospitalization, and (D) death. N denotes total number of participants per study, as numbers per group were usually not available [20,22,23,25,26,27,29,31,32,33,34,35].
Figure 3
Figure 3
Forest plots with point estimates and 95% confidence intervals of odds ratios for A. infection with COVID-19, or B. severe COVID-19 for vaccinated persons with diabetes, compared to vaccinated persons without diabetes. N denotes total number of participants per study, as numbers per group were usually not available. Ad5, Ad5-nCoV-S (CanSino); AZD, AZD-1222 (AstraZeneca); BNT, BNT162b2 (Pfizer); JNJ, JNJ-78436735 (Janssen); mRNA, mRNA-1273 (Moderna) [19,21,24,28,30].
See this image and copyright information in PMC

References

    1. Barron E., Bakhai C., Kar P., Weaver A., Bradley D., Ismail H., Knighton P., Holman N., Khunti K., Sattar N., et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: A whole-population study. Lancet Diabetes Endocrinol. 2020;8:813–822. doi: 10.1016/S2213-8587(20)30272-2. - DOI - PMC - PubMed
    1. Huang I., Lim M.A., 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;14:395–403. doi: 10.1016/j.dsx.2020.04.018. - DOI - PMC - PubMed
    1. Kumar A., Arora A., Sharma P., Anikhindi S.A., Bansal N., Singla V., Khare S., Srivastava A. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab. Syndr. 2020;14:535–545. doi: 10.1016/j.dsx.2020.04.044. - DOI - PMC - PubMed
    1. Baden L.R., El Sahly H.M., Essink B., Kotloff K., Frey S., Novak R., Diemert D., Spector S.A., Rouphael N., Creech C.B., et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N. Engl. J. Med. 2021;384:403–416. doi: 10.1056/NEJMoa2035389. - DOI - PMC - PubMed
    1. Polack F.P., Thomas S.J., Kitchin N., Absalon J., Gurtman A., Lockhart S., Perez J.L., Marc G.P., Moreira E.D., Zerbini C., et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N. Engl. J. Med. 2020;383:2603–2615. doi: 10.1056/NEJMoa2034577. - DOI - PMC - PubMed

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