Lower Incidence of Type 1 Diabetes Seen After Complete Rotavirus Vaccine Series

By Will Boggs MD

June 23, 2019

NEW YORK (Reuters Health) - Receipt of the complete rotavirus vaccine series in infancy is associated with a significant reduction in the incidence of type 1 diabetes in childhood, according to a database study.

"From a scientific point of view, the fact that rotavirus vaccine specifically was associated with lower type 1 diabetes rates rather than other vaccines (DTaP) was an indication that we were getting closer to the etiologic contributors of this disease," Dr. Mary A. M. Rogers of the University of Michigan, in Ann Arbor, told Reuters Health by email.

"Rotavirus infection has been associated with the onset of type 1 diabetes in animal studies," she explained. "Some studies show that part of the rotavirus looks like, or mimics, the structure of one of our immune cells that is known to destroy pancreatic cells in people who are genetically susceptible to this disease. In addition, there was a recent study suggesting that viral infection in the gut may lead to a loss of the normal gut barrier, and that is how certain immune cells find a way to attack the cells in the pancreas - which then leads to type 1 diabetes."

Dr. Rogers's team used information from more than 1.4 million infants included in a private health insurance database to investigate their hypothesis that the rotavirus vaccine might reduce the likelihood of type 1 diabetes in children. The median observation time was three years (range, 1.0 to 16.5 years).

Among children who received the complete rotavirus vaccination series, the incidence of type 1 diabetes per 100,000 person-years was 12.2 (12.4 for girls, 12.0 for boys), compared with 20.5 among children who were partially vaccinated and 20.6 among those who did not receive the vaccine.

This represents a 41% reduction in the incidence of type 1 diabetes in children who received the entire rotavirus vaccination series compared with children who did not receive the vaccine during the same time period. Partial vaccination was not associated with a significant reduction in type 1 diabetes incidence.

Similarly, infants who received the entire rotavirus series had a 33% reduction in the risk of type 1 diabetes when compared with infants who did not get the vaccine in the same years.

In a separate analysis, children who received both the rotavirus vaccination series and DTaP series were 56% less likely to develop type 1 diabetes than children who received only the DTaP series.

"It is important for pediatricians and family doctors to stress to parents the importance of completing the recommended vaccine series," Dr. Rogers said. "Parents should know that sometimes vaccines do more than protect against acute infections - they can sometimes protect against chronic disease, such as type 1 diabetes."

"Rotavirus vaccination, in our study, led to fewer hospitalizations and fewer severe rotavirus infections," she added. "So, less diarrhea, less vomiting, less crying, saving money because your child isn't admitted to the hospital as frequently, and perhaps sparing your child from a lifelong chronic disease with no cure - these are all good reasons to have your child vaccinated."

Dr. Timo Vesikari from Tampere University Hospital, in Finland, who was not involved in the new work, recently examined possible associations between rotavirus vaccination and type 1 diabetes and celiac disease.

"Since the 1990s many investigators have speculated that rotavirus vaccination might increase type 1 diabetes," he told Reuters Health by email. "It now seems that prevention of wild type rotavirus infection is beneficial also for protection against type 1 diabetes."

"The effect of rotavirus vaccine for prevention of celiac disease is actually greater," Dr. Vesikari said.

SOURCE: https://go.nature.com/2L29p9y

Sci Rep 2019.