ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: JAMA Pediatrics 2019, 173, 280–282

Amongst the enteroviruses that have been associated with the development of type 1 diabetes (T1DM) in children, rotavirus infection is the most common. Using publicly available data from Australian national registries, the authors performed interrupted time-series analyses to compare the incidence of newly diagnosed childhood T1DM during the 8 years before the national introduction in 2007 of oral rotavirus vaccine for all infants aged 6 weeks and older versus the 8 years afterwards. National uptake of rotavirus vaccine was high and estimated to be 84%. Between 2000 and 2015, 16 159 new cases of T1DM in children aged 0 to 14 years were recorded by the National Diabetes Services (24.4 cases [95% CI, 22.4–26.7] per 100 000 children).

Interestingly, in the youngest age group, 0 to 4 years, the incidence of T1DM decreased by 15% (rate ratio, 0.85 [95%CI, 0.75–0.97]; P =0.02) after the introduction of oral rotavirus vaccine in 2007. However, in older children, aged 5–9 years and 10 to 14 years, there was no change in T1DM incidence cases or any temporal differences during the entire 16-year period.

These data (here and in paper 10.2) add evidence that introduction of oral rotavirus vaccination into a national immunization program with a high coverage leads to a decline in the incidence T1DM in young children.

In contrast to data from Finland (comprising a smaller number of cases and shorter time frame of observation), these Australian data showed a reduction of T1DM cases in the youngest age group but not in older children. In the meantime, the overall incidence of T1D in Australia is no more rising and seems to have levelled off. Whether this is an effect of the rotavirus vaccination should be verified by a case control linkage study, as the authors have planned. In other countries, such as Germany, RV vaccination has also been implemented in the national vaccination plan, however without this having led to a decrease in the incidence rate in T1D until now.