The Vermont Department of Health  just issued a bulletin recommending hepatitis B vaccine for all PWD less than 60 years age, and encouraging it for PWD over 60. I pasted information from the bulletin below, and wonder if you're seeing similar recommendations from your various state health departments. Our lead endocrinilogist recommends that we let every PWD we see know about this recommendation, and encourage them to get the hepatitis B vaccine. 

Hepatitis B Vaccine for Diabetics

Extensive research demonstrates that there is an increased risk of

hepatitis B virus in the adult population with diabetes. The Advisory

Committee on Immunization Practice (ACIP) recently recommended the

hepatitis B vaccine series for all diabetic adults less than 60 years

, and

those 60 years and older with diabetes

may have the hepatitis B series.

The first recommendation for hepatitis B vaccination was made in 1982. Since that time, a

comprehensive strategy to eliminate hepatitis B virus (HBV) transmission in the U.S. has

evolved. A hallmark of this policy is the universal vaccination of infants to prevent early

childhood HBV infection, and eventually protect adolescents and adults from infection.

Although hepatitis B vaccine is widely available and >90% effective in adults less than 40

years of age, rates of new hepatitis B infection and acute disease are highest among adults.

Over 95% of all adults infected with HBV have acute infection. Data from the National Health

and Examination Survey (NHANES), showed a higher prevalence of past HBV (anti-hepatitis B

core antigen positive) infection among adults 18 years and older with diabetes than those

without (8.2% vs. 5.1%). Data from the 2009-2010 Emerging Infections Program showed an

increased risk for acute HBV infection among adults

≤ 60 years with diabetes.

Since 1990, 24 out of 28 outbreaks of HBV in long-term care facilities were associated with

diabetic adults. Investigations into the cause of these outbreaks found that procedures used

in assisted blood glucose monitoring were the major risk factor for HBV transmission. More than 80% of people with diabetes monitor their blood glucose at least once a

month, and infection control practices alone have not been effective in preventing outbreaks

of HBV among diabetics.

Since 1990, 24 out of 28 outbreaks of HBV in long-term care facilities were associated withdiabetic adults. Investigations into the cause of these outbreaks found that procedures usedin assisted blood glucose monitoring were the major risk factor for HBV transmission. More than 80% of people with diabetes monitor their blood glucose at least once amonth, and infection control practices alone have not been effective in preventing outbreaks of HBV among diabetics.

Thanks Lyn

The above quote from the information you presented caught my eye.

In my experience during the Home Healthcare part of my professional life, I identified more than on assisted care location that was changing the lancet, but using the fingerprick device from patient to patient. Of course, I addressed the practice and sought the assistance of the administration of the institution to institute a policy to prevent such happenings.  The truth is that the blood glucose monitoring is relegated to ancillary personnel who may not fully comprehend infection control practices... and the RN who supposedly monitors care just sets things up but is not on site observing what happens on a daily basis in the "real life" situation.  The only reason that a home care nurse (myself in those instances) was because the ancillary personnel could not inject insulin...they could, however, give pills to patients that were pre-poured by an RN at some time..... all scary stuff for sure. Thus, it is no surprise to me that "infection control practices" referred to in the HepB  statement referred to were not effective....the could be in a book somewhere, but that doesn't mean it reflects reality at a given institution.

I plan on asking my doc about it at my next visit.  I don't want to be at the mercy of lack luster infection practices if I need assisted care later. 

The CDC flyer for the Hepatitis B vaccine now shows the recommendation for vaccination of adults with diabetes under 60.