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
. 2020 May 1;174(5):455-462.
doi: 10.1001/jamapediatrics.2019.6324.

Association Between Rotavirus Vaccination and Type 1 Diabetes in Children

Jason M Glanz  1   2 , Christina L Clarke  1 , Stanley Xu  1 , Matthew F Daley  1 , Jo Ann Shoup  1 , Emily B Schroeder  1   3 , Bruno J Lewin  4 , David L McClure  5 , Elyse Kharbanda  6 , Nicola P Klein  7 , Frank DeStefano  8
Affiliations

Association Between Rotavirus Vaccination and Type 1 Diabetes in Children

Jason M Glanz et al. JAMA Pediatr. .

Abstract

Importance: Because rotavirus infection is a hypothesized risk factor for type 1 diabetes, live attenuated rotavirus vaccination could increase or decrease the risk of type 1 diabetes in children.

Objective: To examine whether there is an association between rotavirus vaccination and incidence of type 1 diabetes in children aged 8 months to 11 years.

Design, setting, and participants: A retrospective cohort study of 386 937 children born between January 1, 2006, and December 31, 2014, was conducted in 7 US health care organizations of the Vaccine Safety Datalink. Eligible children were followed up until a diagnosis of type 1 diabetes, disenrollment, or December 31, 2017.

Exposures: Rotavirus vaccination for children aged 2 to 8 months. Three exposure groups were created. The first group included children who received all recommended doses of rotavirus vaccine by 8 months of age (fully exposed to rotavirus vaccination). The second group had received some, but not all, recommended rotavirus vaccines (partially exposed to rotavirus vaccination). The third group did not receive any doses of rotavirus vaccines (unexposed to rotavirus vaccination).

Main outcomes and measures: Incidence of type 1 diabetes among children aged 8 months to 11 years. Type 1 diabetes was identified by International Classification of Diseases codes: 250.x1, 250.x3, or E10.xx in the outpatient setting. Cox proportional hazards regression models were used to analyze time to type 1 diabetes incidence from 8 months to 11 years. Hazard ratios and 95% CIs were calculated. Models were adjusted for sex, race/ethnicity, birth year, mother's age, birth weight, gestational age, number of well-child visits, and Vaccine Safety Datalink site.

Results: In a cohort of 386 937 children (51.1% boys and 41.9% non-Hispanic white), 360 169 (93.1%) were fully exposed to rotavirus vaccination, 15 765 (4.1%) were partially exposed to rotavirus vaccination, and 11 003 (2.8%) were unexposed to rotavirus vaccination. Children were followed up a median of 5.4 years (interquartile range, 3.8-7.8 years). The total person-time follow-up in the cohort was 2 253 879 years. There were 464 cases of type 1 diabetes in the cohort, with an incidence rate of 20.6 cases per 100 000 person-years. Compared with children unexposed to rotavirus vaccination, the adjusted hazard ratio was 1.03 (95% CI, 0.62-1.72) for children fully exposed to rotavirus vaccination and 1.50 (95% CI, 0.81-2.77) for children partially exposed to rotavirus vaccination.

Conclusions and relevance: The findings of this study suggest that rotavirus vaccination does not appear to be associated with type 1 diabetes in children.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Drs Glanz, Shoup, Lewin, Kharbanda, and Klein and Ms Clarke reported receiving grants from the Centers for Disease Control and Prevention during the conduct of the study. Dr Schroeder reported receiving grants from the National Institute of Diabetes and Digestive and Kidney Diseases during the conduct of the study. Dr Klein reported receiving grants from Merck & Co, GlaxoSmithKline, Sanofi Pasteur, Pfizer, Protein Science (now Sanofi Pasteur), Dynavax, and MedImmune outside the submitted work. No other disclosures were reported.

References

    1. American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(suppl 1):S81-S90. doi: 10.2337/dc14-S081 - DOI - PubMed
    1. Rogers MAM, Kim C, Banerjee T, Lee JM. Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study. BMC Med. 2017;15(1):199. doi: 10.1186/s12916-017-0958-6 - DOI - PMC - PubMed
    1. Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet. 2016;387(10035):2340-2348. doi: 10.1016/S0140-6736(16)30507-4 - DOI - PMC - PubMed
    1. Honeyman M. How robust is the evidence for viruses in the induction of type 1 diabetes? Curr Opin Immunol. 2005;17(6):616-623. doi: 10.1016/j.coi.2005.09.007 - DOI - PubMed
    1. Honeyman MC, Laine D, Zhan Y, Londrigan S, Kirkwood C, Harrison LC. Rotavirus infection induces transient pancreatic involution and hyperglycemia in weanling mice. PLoS One. 2014;9(9):e106560. doi: 10.1371/journal.pone.0106560 - DOI - PMC - PubMed

Publication types

Substances