Association of Rotavirus Vaccination With the Incidence of Type 1 Diabetes in Children

Abstract

Rotavirus (RV) infection has been associated with the development of type 1 diabetes (T1D) in children. 1 Rotavirus infection triggers pancreatic apoptosis in mice, and RV peptides display molecular mimicry with T-cell epitopes in pancreatic β-cell autoantigens. 2 We hypothesized that if natural infection with RV was a causative factor in T1D, then RV vaccination would decrease the incidence of disease over time. Therefore, using publicly available data, we examined the incidence of T1D in Australian children before and after the oral RV vaccine was introduced to the Australian National Immunisation Program in 2007. Methods | An interrupted time-series analysis was performed on the incidence of newly diagnosed T1D in Australian children in the 8 years before compared with the 8 years after the May 2007 introduction of routine oral RV vaccination for all infants aged 6 weeks and older. National coverage for RV vaccine at this time was estimated to be 84%. Nearly all Australian children newly diagnosed with T1D are registered with the National Diabetes Services Scheme for subsidized provision of glucose testing and insulin delivery consumables (https:// www.ndss.com.au/). National Diabetes Services Scheme data are provided to the Australian Institute of Health and Welfare (https://www.aihw.gov.au/). Using the publicly available data from this source, we determined the observed and modeled rates of new-onset T1D between 2000 and 2015. Population numbers for children aged 0 to 4 years, 5 to 9 years, and 10 to 14 years in Australia over this period were sourced from the Australian Bureau of Statistics website (http://www.abs.gov. au/). Interrupted time-series modeling of preintervention and

Early-life factors contributing to type 1 diabetes

“…Rotaviruses Recent reports from Australia and the USA have demonstrated a reduced incidence of type 1 diabetes in young children following the introduction of rotavirus vaccination [72,73].…”

Large enteroviral vaccination studies to prevent type 1 diabetes should be well founded and rely on scientific evidence. Reply to Skog O, Klingel K, Roivainen M et al [letter]

“…We expect that the outcome of such vaccination studies will establish or disprove a role for enteroviruses in type 1 diabetes. Supporting this notion, we are interested to note the very recent publication of an Australian study reporting a decreased incidence of type 1 diabetes following the introduction of a rotavirus vaccine [20]. The authors cite previous evidence associating rotavirus infections with type 1 diabetes [20,21] and the possibility should not be overlooked that co-infection with rotavirus and other viruses (including different enterovirus types) might contribute to the development of type 1 diabetes.…”

Typ-1-Diabetes: Früherkennung und Ansätze zur Prävention

“…Dervorfast15 Jahreneingeführten Rotavirenimpfung wird ein kürzlich festgestellter geringer Rückgang der Diabetesinzidenz bei vollständig geimpften Kindern zugeschrieben. Hinweise hierzu lieferten retrospektive Auswertungen aus Australien und den USA [24,27], wobei die Ergebnisse einer weiteren amerikanischen Analyse dies zuletzt wieder in Frage stellten [11]. Zumindest lässt sich sicher sagen, dass auch die Rotavirenimpfungso wie alle anderen empfohlenen Schutzimpfungen -sich keinesfalls negativ auf das Typ-1-Diabetes-Risiko auswirkt.…”