Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2025 Aug;48(8):1717-1738.
doi: 10.1007/s40618-025-02586-5. Epub 2025 Apr 23.

Vaccination of people with solid tumors and diabetes: existing evidence and recommendations. A position statement from a multidisciplinary panel of scientific societies

Marco Gallo  1 , Angioletta Lasagna  2 , Valerio Renzelli  3 , Lelio Morviducci  4 , Alessio Cortellini  5   6   7 , Matteo Monami  8 , Giampiero Marino  9 , Stefania Gori  10 , Matteo Verzé  10 , Alberto Ragni  11 , Enzo Tuveri  12 , Laura Sciacca  13 , Stella D'Oronzo  14 , Dario Giuffrida  15 , Annalisa Natalicchio  16 , Francesco Giorgino  16 , Nicola Marrano  16 , Maria Chiara Zatelli  17 , Monica Montagnani  18 , Francesco Felicetti  19 , Rossella Mazzilli  20 , Stefano Fogli  21 , Tindara Franchina  22 , Antonella Argentiero  23 , Riccardo Candido  24 , Francesco Perrone  25 , Gianluca Aimaretti  26 , Angelo Avogaro  27 , Nicola Silvestris  23 , Antongiulio Faggiano  20
Affiliations
Practice Guideline

Vaccination of people with solid tumors and diabetes: existing evidence and recommendations. A position statement from a multidisciplinary panel of scientific societies

Marco Gallo et al. J Endocrinol Invest. 2025 Aug.

Abstract

Diabetes and cancer are two of the most common public health concerns worldwide. The complex interplay of these two conditions is a growing area of research, as patients with diabetes are at increased risk for developing cancer, and vice versa. Furthermore, both patient populations show increased risk of many communicable infectious diseases and their adverse consequences, while vaccination can play a crucial role in their prevention, improving patient outcomes. Vaccination should represent a standard part of care for patients with cancer, diabetes, and both the diseases simultaneously, including people undergoing cancer treatment or in remission. Several international guidelines provide recommendations for vaccinating people with cancer or diabetes, but the two conditions have not been specifically evaluated together. Here we present a multidisciplinary consensus position paper on vaccination in patients with cancer and diabetes. The position paper is the result of a collaborative effort between experts from the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF). The paper provides a comprehensive overview of the current state-of-the-art knowledge on vaccination in patients with cancer and diabetes. It discusses the importance of vaccination in preventing infections, focuses attention on the need to consider the unique challenges faced by patients with cancer and diabetes when it comes to vaccine administration, and highlights the need for coordinated care to optimize treatment outcomes. Overall, the consensus position paper provides healthcare professionals caring for patients with cancer and diabetes recommendations on the use of various vaccines, including influenza, COVID-19, HZV, and HPV vaccines, as well as guidance on how to address common concerns and challenges related to vaccine administration.

Keywords: COVID-19; Cancer; Diabetes; Immunocompromised; Influenza; Pneumonitis; Vaccine hesitancy; Vaccine-preventable diseases (VPDs); Vaccines.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: M.G. has received honoraria for speaker fees and/or travel grants for scientific meetings from AAA, AstraZeneca, Boehringer-Ingelheim, Bruno Farm., Eli-Lilly, IBSA, Lifescan, Mundipharma, Novo Nordisk and Sanofi, and served on scientific advisory panels for Boehringer-Ingelheim, Merck Sharp & Dohme and Novo Nordisk. A.L. declares grants for consultancies/advisory boards from GSK, and speaking fees from Astrazeneca, GSK, Novartis, Pfizer. V.R. has received a travel grant from Androlabs. A.N. has served as a speaker for AstraZeneca, Lilly Boehringher, Novo Nordisk, and Sanofi Aventis. F.G. has served as an advisor for AstraZeneca, Eli Lilly and Novo Nordisk; has served as a research investigator for Eli Lilly and Roche Diabetes Care; has served as a speaker for AstraZeneca and Eli Lilly; has served as a consultant for AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novo Nordisk, Roche Diabetes Care and Sanofi; has received grants from Eli Lilly, Lifescan and Roche Diabetes Care; leadership in scientific society: Senior Vice President of EASD. S.F. serves on the scientific advisory board of, has a consulting relationship with and reports receiving support for travel expenses from Novartis, Teva, Roche, BMS, Lilly and Ipsen. R.C. has received grants and consultancy or lecture fees from Abbott, AstraZeneca, Bayer, Boehringer, Lilly, MSD, Menarini Diagnostics, Mundipharma, Novo Nordisk, Roche Diabetes Care, and Sanofi. G.A. has received grants from Eli Lilly and Novo Nordisk. N.S. received fees for consulting from Roche, Lilly, Servier. All other authors have declared no conflicts of interest. Ethics approval: Not applicable.

Figures

Fig. 1
Fig. 1
Mechanisms by which cancer and diabetes can increase the risk of contracting infections or developing more serious consequences
Fig. 2
Fig. 2
Efficacy, safety and precautions of vaccination in patients with cancer and diabetes
Fig. 3
Fig. 3
(A) Flu vaccine significantly reduces the risk of lung cancer in patients with diabetes. (B) Administration of flu vaccine by intra-tumor injection in mice with lung cancer sensitizes tumors to PD-L1 checkpoint inhibitors. Created with BioRender.com
Fig. 4
Fig. 4
Tentative decision-making algorithm for vaccinating cancer patients with diabetes
See this image and copyright information in PMC

References

    1. World Health Organization (2024) Development of WHO immunization policy and strategic guidance: methods and processes applied by the Strategic Advisory Group of Experts on Immunization (SAGE) to develop evidence-based recommendations
    1. Doherty M, Schmidt-Ott R, Santos JI et al (2016) Vaccination of special populations: protecting the vulnerable. Vaccine 34:6681–6690. 10.1016/j.vaccine.2016.11.015 - PubMed
    1. Pedrazzoli P, Lasagna A, Cassaniti I et al (2023) Vaccination for seasonal influenza, Pneumococcal infection and SARS-CoV-2 in patients with solid tumors: recommendations of the associazione Italiana Di oncologia medica (AIOM). ESMO Open 8:101215. 10.1016/j.esmoop.2023.101215 - PMC - PubMed
    1. Kamboj M, Bohlke K, Baptiste DM et al (2024) Vaccination of adults with cancer: ASCO guideline. J Clin Oncol 42:1699–1721. 10.1200/JCO.24.00032 - PMC - PubMed
    1. Pedrazzoli P, Baldanti F, Donatelli I et al (2014) Vaccination for seasonal influenza in patients with cancer: recommendations of the Italian society of medical oncology (AIOM). Ann Oncol 25:1243–1247. 10.1093/annonc/mdu114 - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources