Rotavirus vaccine comes with lower risk of type 1 diabetes

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Babies who are fully vaccinated against rotavirus in the first months of life have a 33 percent lower risk of developing type 1 diabetes than their unvaccinated peers, a new study reports.

Rotavirus, which hits infants and toddlers hardest, can cause diarrhea and vomiting that can lead to dehydration or loss of fluids. Type 1 diabetes is a lifelong disease with no known prevention strategies or cure.

The study in Scientific Reports offers strong evidence that the rotavirus vaccine works, researchers say. Children vaccinated against rotavirus had a 94 percent lower rate of hospitalization for rotavirus infection, and a 31 percent lower rate of hospitalization for any reason, in the first two months after vaccination.

The Centers for Disease Control and Prevention recommends that infants receive the multidose vaccine starting no later than 15 weeks and finish receiving it before they are 8 months old. Infants receive the vaccine in oral drops.

The study shows that more than a quarter of American children don’t get fully vaccinated against rotavirus and that rates vary nationwide. Less than half of children in New England and Pacific states receive a full round, compared to two-thirds of children in the central part of the country who are fully vaccinated.

A trend to watch

The study does not show a cause-and-effect relationship between rotavirus vaccination and type 1 diabetes risk, cautions Mary A.M. Rogers, associate professor in the internal medicine department at the University of Michigan.

“This is an uncommon condition, so it takes large amounts of data to see any trends across a population. It will take more time and analyses to confirm these findings. But we do see a decline in type 1 diabetes in young children after the rotavirus vaccine was introduced.”

The death of insulin-producing cells, called beta cells, means people with type 1 diabetes depend on injections of insulin and multiple daily checks of their blood sugar for life. If the condition is not managed well, people with type 1 diabetes may develop problems with their kidneys, heart, eyes, blood vessels, and nerves.

8 fewer cases per 100,000 kids

Researchers used anonymous insurance data from 1.5 million American children born before and after the modern rotavirus vaccine came out in 2006. In nearly all cases, the vaccine was free, with no copayment from the family of the infant. The lifetime cost of caring for a person with type 1 diabetes has been estimated in the millions of dollars.

The risk was especially lower among children who received all three doses of the pentavalent form of the vaccine than those who received two doses of the monovalent form. The pentavalent rotavirus vaccine protects against five types of the rotavirus, while the monovalent vaccine protects against one type.

Children who started the vaccine series but never finished it did not have a lower risk of type 1 diabetes.

More than 540,000 children in the study who were born after 2006 received the complete series of the rotavirus vaccine and nearly 141,000 received at least one dose. The comparison group, born in the five years before the vaccine was available, included nearly 547,000 children.

In absolute terms, the researchers report that 8 fewer cases of type 1 diabetes occurred for every 100,000 children each year with full vaccination.

Fewer new cases to come?

Type 1 diabetes, once called juvenile diabetes, affects only a few children out of every 100,000, so having such a large pool of data can help spot trends, Rogers says.

“Five years from now, we will know much more,” Rogers says. “The first groups of children to receive the rotavirus vaccine in the United States are now in grade school, when type 1 diabetes is most often detected.

“Hopefully in years to come, we’ll have fewer new cases—but based on our study findings, that depends upon parents bringing in their children to get vaccinated.”

The National Institutes of Health funded the work.

Source: University of Michigan