Rotavirus vaccination linked to reduced type 1 diabetes risk
medwireNews: Findings from a US cohort study suggest that children who have received rotavirus vaccination have a significantly lower risk for developing type 1 diabetes than those who have not been given the vaccine.
“While additional studies are needed to explore this association in more detail, it is possible that rotavirus vaccination may be the first practical measure that could play a role in the prevention of [type 1 diabetes],” Mary Rogers (University of Michigan, Ann Arbor, USA) and fellow researchers write in Scientific Reports.
Rogers and team found that among the 540,317 participants who received the complete rotavirus vaccination series (three doses of the RotaTeq vaccine or two doses of the Rotarix vaccine) between 2006 and 2017, 0.035% developed diabetes over an average 2.91 years of follow-up.
By comparison, 0.058% of the 140,646 partially vaccinated children (those who received at least one dose but did not complete the full series) developed diabetes during 2.81 years of follow-up, while 0.067% of the 246,600 who did not receive any rotavirus vaccination developed diabetes over 3.26 years.
These findings translated into diabetes incidence rates of 12.2, 20.5, and 20.6 per 100,000 person–years for the completely vaccinated, partially vaccinated, and unvaccinated groups, respectively, and an incidence rate ratio of 0.59 for fully vaccinated versus unvaccinated individuals. There was no significant difference in diabetes incidence rates among partially vaccinated versus unvaccinated people.
In a Cox proportional hazards regression model, children who completed the vaccination series had a significant 33% lower risk for developing diabetes than those in the unvaccinated group after adjustment for sex, season of birth, and geographic region.
The incidence of diabetes was also significantly lower among the completely vaccinated children compared with a historical cohort of 546,972 individuals who were not vaccinated between 2001 and 2005 and followed up for an average of 4.12 years, with an incidence rate ratio of 0.45.
Rogers et al note that “the vast majority of the infants who received the rotavirus vaccine also received the vaccine for diphtheria, tetanus, and pertussis [DTaP] on the same days,” which led to the question of whether “it was specifically the rotavirus vaccine (rather than the other vaccines) that was associated with the onset of type 1 diabetes.”
They found that children vaccinated for both rotavirus and DTaP had a significant 44% lower risk for developing diabetes than those given the DTaP vaccine only, which “provides evidence that it is the rotavirus vaccine, itself, that may be involved in the etiology of type 1 diabetes.”
Discussing the putative mechanisms underlying this association, the researchers say that rotavirus infection has been shown to accelerate beta-cell destruction in mice, and rotavirus infection is known to be associated with islet autoantibody levels.
They caution that their study was not able to demonstrate a causal relationship, and they were not able to establish “whether the rotavirus vaccine is associated with a lower lifetime risk of developing type 1 diabetes or whether it merely delays the onset of the disease.”
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