瑞典儿童 1 型糖尿病发病率与轮状病毒疫苗接种无关。

No association between incidence of type 1 diabetes and rotavirus vaccination in Swedish children.

机构信息

Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Futurum - Academy of Health and Care, Region Jönköping County, Jönköping, Sweden.

出版信息

Front Immunol. 2023 Aug 10;14:1175071. doi: 10.3389/fimmu.2023.1175071. eCollection 2023.

DOI:10.3389/fimmu.2023.1175071

PMID:37638044

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10456946/

Abstract

BACKGROUND

Rotavirus infection is a potential trigger of type 1 diabetes (T1D) and rotavirus vaccination is hypothesized to decrease the incidence of T1D. In Sweden, rotavirus vaccination was introduced in 2014 in two regions and from 2019, nationwide. This study aims to investigate the association between rotavirus vaccination and incidence of T1D in Swedish children and whether rotavirus vaccination is associated with a change in clinical manifestation at diabetes onset.

METHODS

A nationwide register-based study with all Swedish children <15 years of age, diagnosed with T1D 2009-2019 was conducted. 7893 children were retrieved. Nationwide vaccine coverage was collected from Child Health Services. Three vaccine groups were created: I: Vaccination start 2014; II: Gradual vaccination start 2016-2018; III: No vaccination. Incidence rates of T1D before (2009-2014) and after (2014-2019) introduction of rotavirus vaccine were compared.

FINDINGS

The mean incidence of T1D in children <15 years was 42·61 per 100 000 during the observed period. When comparing the years before and after 2014 the incidence rate ratio (IRR) for children <5 years was 0·86 in group I (p=0·10), 0·85 (p=0·05) in group II and 0·87 (p=0·06) in group III. A similar IRR reduction was also seen among older children who received no vaccine. Children developing or not developing T1D were vaccinated to the same extent. No differences regarding clinical manifestation at onset associated with rotavirus vaccination were seen.

INTERPRETATION

There is no association between rotavirus vaccination in children and incidence or clinical manifestation of T1D.

摘要

背景

轮状病毒感染是 1 型糖尿病（T1D）的潜在诱因，轮状病毒疫苗接种被假设可以降低 T1D 的发病率。在瑞典，轮状病毒疫苗于 2014 年在两个地区引入，并于 2019 年在全国范围内引入。本研究旨在调查瑞典儿童中轮状病毒疫苗接种与 T1D 发病率之间的关系，以及轮状病毒疫苗接种是否与糖尿病发病时临床表现的变化有关。

方法

进行了一项全国范围内的基于登记的研究，纳入了 2009 年至 2019 年期间被诊断为 T1D 的所有<15 岁的瑞典儿童。共检索到 7893 名儿童。从儿童保健服务中收集了全国范围内的疫苗接种覆盖率。创建了三个疫苗接种组：I 组：2014 年开始接种；II 组：2016-2018 年逐步开始接种；III 组：未接种。比较轮状病毒疫苗引入前后（2009-2014 年和 2014-2019 年）T1D 的发病率。

结果

在观察期间，<15 岁儿童的 T1D 平均发病率为每 100000 人 42.61 例。与 2014 年之前相比，比较 5 岁以下儿童的发病率比值比（IRR），I 组为 0.86（p=0.10），II 组为 0.85（p=0.05），III 组为 0.87（p=0.06）。未接种疫苗的较大儿童也观察到类似的 IRR 降低。发生或未发生 T1D 的儿童接种疫苗的程度相同。未观察到轮状病毒疫苗接种与 T1D 发病时临床表现相关的差异。