Lower Incidence Rate of Type 1 Diabetes after Receipt of the Rotavirus Vaccine in the United States, 2001–2017

Rogers, Mary A.M.; Basu, Tanima; Kim, Catherine

doi:10.1038/s41598-019-44193-4

Cited by 88 publications

(57 citation statements)

References 15 publications

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“…Rotavirus vaccination introduced in many countries in the 2000s, was not significantly associated with type 1 diabetes in children in Finland, 136 but a suggestive lower incidence was seen in vaccinees in Australia 137 and USA. 138 Follow-up of participants from a randomised trial of RotaTeq in Finland did not find any significant difference in incidence of type 1 diabetes after 12-14 years. 139 Overall, vaccines are unlikely to explain the changing epidemiology of type 1 diabetes, but further studies of rotavirus vaccines are warranted.…”

Section: Helminthsmentioning

confidence: 89%

Type 1 diabetes—early life origins and changing epidemiology

Norris

Johnson

Stene

2020

The Lancet Diabetes & Endocrinology

231

171

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Type 1 diabetes is a chronic, immune-mediated disease characterised by the destruction of insulinproducing cells. Standardised registry data show that type 1 diabetes incidence has increased 3-4% over the past three decades, supporting the role of environmental factors. Although several factors have been associated with type 1 diabetes, none of the associations are of a magnitude that could explain the rapid increase in incidence alone. Moreover, evidence of changing prevalence of these exposures over time is insufficient. Multiple factors could simultaneously explain the changing type 1 diabetes incidence, or the magnitude of observed associations could have been underestimated because of exposure measurement error, or the mismodelling of complex exposure-time-response relationships. The identification of environmental factors influencing the risk of type 1 diabetes and increased understanding of the cause at the individual level, regardless of the ability to explain the changing incidence at the population level, is important because of the implications for prevention.

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Section: Helminthsmentioning

confidence: 89%

Type 1 diabetes—early life origins and changing epidemiology

Norris

Johnson

Stene

2020

The Lancet Diabetes & Endocrinology

231

171

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“…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].…”

Section: Virusesmentioning

confidence: 99%

Early-life factors contributing to type 1 diabetes

et al. 2019

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The incidence of type 1 diabetes has increased since the mid-twentieth century at a rate that is too rapid to be attributed to genetic predisposition alone. While the disease can occur at any age, mounting evidence from longitudinal cohort studies of at-risk children indicate that type 1 diabetes associated autoantibodies can be present from the first year of life, and that those who develop type 1 diabetes at a young age have a more aggressive form of the disease. This corroborates the hypothesis that environmental exposures in early life contribute to type 1 diabetes risk, whether related to maternal influences on the fetus during pregnancy, neonatal factors or later effects during infancy and early childhood. Studies to date show a range of environmental triggers acting at different time points, suggesting a multifactorial model of genetic and environmental factors in the pathogenesis of type 1 diabetes, which integrally involves a dialogue between the immune system and pancreatic beta cells. For example, breastfeeding may have a weak protective effect on type 1 diabetes risk, while use of an extensively hydrolysed formula does not. Additionally, exposure to being overweight pre-conception, both in utero and postnatally, is associated with increased risk of type 1 diabetes. Epidemiological, clinical and pathological studies in humans support a role for viral infections, particularly enteroviruses, in type 1 diabetes, but definitive proof is lacking. The role of the early microbiome and its perturbations in islet autoimmunity and type 1 diabetes is the subject of investigation in ongoing cohort studies. Understanding the interactions between environmental exposures and the human genome and metagenome, particularly across ethnically diverse populations, will be critical for the development of future strategies for primary prevention of type 1 diabetes.

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“…Because rotavirus vaccination during infancy has been shown to lower rates of diabetes in childhood, the results were adjusted for completion of the rotavirus vaccine series (Table ). After adjustment, congenital infections and other perinatal infections remained significantly associated with the incidence of diabetes.…”

Section: Resultsmentioning

confidence: 99%

Congenital infections as contributors to the onset of diabetes in children: A longitudinal study in the United States, 2001‐2017

Rogers

Kim

2020

Pediatr Diabetes

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Background: Maternal infections during pregnancy, particularly with rubella virus, were reported to increase the risk of diabetes in children. Widespread vaccination has decreased the number of infants with congenital rubella syndrome in the United States, although it remains a problem in developing countries. Because vaccine hesitancy has recently increased, we investigated the association between congenital infections with subsequent diabetes risk in children in the United States.Methods: Using data from a nationwide private health insurer for years 2001-2017, 1 475 587 infants were followed for an average of 3.9 years (maximum 16.5 years).Information was obtained regarding congenital infections (rubella, cytomegalovirus, other congenital infections) and perinatal infections, as well as for the development of diabetes mellitus and diabetic ketoacidosis.Results: There were 781 infants with congenital infections and 73 974 with perinatal infections. Diabetes developed in 3334 children. The odds of developing diabetes for infants with congenital rubella infection were 12-fold greater (P = .013) and, for infants with congenital cytomegalovirus infection, were 4-fold greater (P = .011) than infants without congenital or perinatal infection. Infants with other congenital infections had 3-fold greater odds of developing diabetes (P = .044). Results were similar for diabetes ketoacidosis. Infants with other perinatal infections had 49% greater odds of developing diabetes during the follow-up period (P < .001).Conclusion: Congenital and other perinatal infections are associated with elevated risks of developing diabetes mellitus during childhood. Vaccination for rubella remains an important preventive action to reduce the incidence of diabetes in children. K E Y W O R D S congenital infection, cytomegalovirus, diabetes, rubella

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Lower Incidence Rate of Type 1 Diabetes after Receipt of the Rotavirus Vaccine in the United States, 2001–2017

Cited by 88 publications

References 15 publications

Type 1 diabetes—early life origins and changing epidemiology

Type 1 diabetes—early life origins and changing epidemiology

Early-life factors contributing to type 1 diabetes

Congenital infections as contributors to the onset of diabetes in children: A longitudinal study in the United States, 2001‐2017

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