Vaccination and diabetes: “Take a rational approach to your children’s health.”
How the mom of a 16-year-old boy with diabetes overcame her scepticism regarding COVID-19 and flu vaccines
Six years ago, the Yerulanovs family’s life changed forever when doctors diagnosed nine-year-old Yerasyl with Type 1 diabetes. The diagnosis came after he showed specific symptoms, requiring the family to call an ambulance, and his hospitalization in the intensive care unit. The doctors confirmed that Yerasyl’s body did not produce sufficient amounts of insulin, and now, he has to inject himself with the hormone to regulate his blood sugar level every day. According to the latest figures, more than 1.2 million children and adolescents worldwide are living with Type 1 diabetes.
Aizhan Yerulanova, Yerasyl’s mother, said, “I took the news calmly because I’m a sensible person, and he also reacted calmly to the diagnosis. We didn’t panic, but of course, we were worried and scared. It was a difficult time for us, but we’ve learned to live with the condition.” The family’s major challenge was changing their daily habits, she recalls. For example, the schoolboy had to adhere to a strict eating schedule and keep track of his carbohydrates.
Aizhan explained, “The most challenging part was using the glucometer. The frequent measurements were stressful for us, and we still haven’t switched to electronic monitoring. We continue to use the test strips and injection pens provided by the hospital. Yerasyl has adapted well, and I have also become accustomed to the process. It’s not easy, but we have no other option.”
Today, Aizhan teaches at the East Kazakhstan Technical University, while Yerasyl, who is now 16, is studying to be an electrical engineer at the Ust-Kamenogorsk Higher Polytechnic College. He has a passion for computers, is learning English, and enjoys sports.
Late last year, Aizhan came across a chat room message for parents of children with diabetes. The Diabetes Association of the Republic of Kazakhstan (DARK), in collaboration with the United Nations Children’s Fund (UNICEF) and with financial support from the United States Agency for International Development (USAID), organized a training event. The training covered topics including myths about routine immunization and vaccination against COVID-19, caring for children with diabetes after COVID-19, and taking safety precautions during the pandemic. Aizhan, joined by 70 other parents, decided to participate.
Speaking about her impression of the event, Aizhan recalled: “For the first time in my life, I attended an event specifically organized for children with diabetes. Such events should be held more often, and children should be invited to participate along with parents.” Aizhan notes that in Ust-Kamenogorsk, parents sometimes lack even basic information on how to manage the lives of children with diabetes. “We don’t have such training opportunities in our city. There is no [diabetes] school, as far as I know, let alone educational events on vaccinations,” adds Aizhan.
She never doubted the necessity of routine immunization: “My son and I received all of our routine vaccines from birth to age 10. He has a vaccination passport, and I keep track of the vaccines’ statuses. We had a positive attitude about vaccinations,” Aizhan says about her and her son. However, the coronavirus pandemic caught the family off-guard, she admits: “We all panicked. We didn’t know what to do. What would we do if the child contracted the virus? We had our primary diagnosis already.”
The doctor treating Yerasyl did not say anything about the COVID-19 vaccine to Aizhan, and there was only “negative information about the vaccination when the very first batch of these vaccines came to Kazakhstan,” Aizhan notes. At that time, there were no discussions about the need to vaccinate children with diabetes, she says. It was during the DARK training course that Aizhan learned that “children with diabetes should be vaccinated [against COVID-19].”
People with diabetes are at higher risk of severe complications from vaccine-preventable diseases. They also run a higher risk of complications from hepatitis B, influenza, and pneumonia compared to the general population. Aizhan fully agrees: “They [children with diabetes] must be vaccinated and get any vaccine as soon as possible – including for the flu, coronavirus, pertussis, and diphtheria – to minimize possible complications because the complications are always bad. Influenza is still out there, and we need to get the flu vaccine for our children with diabetes. We should have gotten vaccinated against coronavirus, too.”
While Aizhan doesn’t doubt the benefits of vaccination, she prefers to be responsible when it comes to Yerasyl’s health. Before vaccinating him against the coronavirus, the family will definitely consult a doctor. “Currently, Yerasyl is in puberty, a period when his body is growing and his sugar levels are elevated. Vaccination is not recommended when blood sugar is high,” and Aizhan explains that they want to better regulate his sugar levels before getting the COVID-19 vaccine. Although Aizhan’s approach is rational, she admits that myths surrounding vaccinations may still be affecting her decisions.
For example, this season Yerasyl did not receive the flu shot due to speculation on messaging platforms about the dangers of the vaccine. Unfortunately, false narratives about the safety of preventive vaccinations are utterly common. In reality, when a vaccine is being licensed, it is tested for both safety and efficacy. After the licensing, the monitoring continues, and any serious adverse side effects are thoroughly investigated.
The training that Aizhan attended also addressed common myths about vaccination and diabetes. Speaking to parents who may still have doubts about vaccinating their children with diabetes, Aizhan emphasizes: “Your child’s health is in your hands, so you should take a rational approach to your children’s health, to your own health. This is of crucial importance. Preventing a disease is better than dealing with the consequences. It is better to have the flu with mild symptoms than cope with complications.” Aizhan also highlighted the benefits of vaccination, citing a study that showed a reduction of hospitalizations among diabetic patients by more than 70 per cent due to increased flu vaccination during epidemics.
Today, Aizhan and her son are waiting for a call from a nurse at a health clinic; the family is getting ready to be vaccinated against diphtheria and tetanus. According to the national calendar, this vaccine is first administered to children at 16, followed by a booster shot every 10 years. Aizhan also regularly receives a Td vaccine. “You have to be vaccinated to prevent the risk of disease, whether it’s tuberculosis or rubella. As they say, being informed is like being armed. Once the body has received the vaccine, it’s protected,” concludes Yerasil’s mother with conviction.
 International Diabetes Federation, IDF Diabetes Atlas 10th Edition, 2021, https://diabetesatlas.org/atlas/tenth-edition/, accessed March 2, 2023.
 American Diabetes Association, Flu and Pneumonia Shots, <https://diabetes.org/healthy-living/medication-treatments/flu-and-pneumonia-shots>, accessed March 2, 2023.
 Colquhoun, A.J., K.G. Nicholson, J. L. Botha, and N. T. Raymond, ‘Effectiveness of Influenza Vaccine in Reducing Hospital Admissions in People with Diabetes,’ Epidemiology & Infection, vol. 119, no. 3, December 1997, pp. 335–341,< https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809006/>, accessed March 2, 2023.