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Peer-reviewedCC BY 4.0Diabetologia

Rotavirus vaccination and incidence of type 1 diabetes: a population-based natural experiment

  • Maria Östman1
  • Ketil Størdal2,3
  • German Tapia4
  • Lars C. Stene4
4 affiliations
  1. 1Faculty of Medicine, University of Oslo, Oslo, Norway
  2. 2Department of Paediatric Research, University of Oslo, Oslo, Norway
  3. 3Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
  4. 4Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
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Abstract

Aims/hypothesis: Environmental factors, including infections, have been suspected to influence the risk of type 1 diabetes. Studies of rotavirus vaccine and risk of type 1 diabetes have shown conflicting results. We took advantage of the rapid and high uptake of the rotavirus vaccine among infants in Norway as a natural experiment to study the potential association between rotavirus vaccination and type 1 diabetes incidence in Norway.

Methods: In this cohort study, we followed all children born in Norway during 2007–2019 from 6 months to 5 years of age for type 1 diabetes. In an interrupted time series analysis, we compared type 1 diabetes incidence in children born before compared with after introduction of the rotavirus vaccination programme in September 2014.

Results: Of 740,744 included children, 846 were diagnosed with type 1 diabetes between 6 months and 5 years of age. Our primary interrupted time series analysis showed an increasing trend after implementation of the rotavirus vaccination programme (relative HR 1.11 [95% CI 1.03, 1.20]), which was not significant after excluding birth cohorts from 2013–2015 to avoid potential herd immunity effects (relative HR 1.05 [95% CI 0.93, 1.18]). In a secondary analysis comparing fully vaccinated with non-vaccinated children, the adjusted HR was 1.17 (95% CI 0.78, 1.77).

Conclusions/Interpretation: This study found no evidence for a reduced risk of type 1 diabetes after introduction of rotavirus vaccination in infancy.

Graphical Abstract:

Supplementary Information: The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/s00125-026-06832-0.

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Cite

BibTeXRIS
BibTeX
@article{ostman2026rotavirus,
  title = {{Rotavirus vaccination and incidence of type 1 diabetes: a population-based natural experiment}},
  author = {Maria Östman and Ketil Størdal and German Tapia and Lars C. Stene},
  journal = {Diabetologia},
  year = {2026},
  month = aug,
  doi = {10.1007/s00125-026-06832-0},
  url = {https://doi.org/10.1007/s00125-026-06832-0},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Rotavirus vaccination and incidence of type 1 diabetes: a population-based natural experiment
AU  - Maria Östman
AU  - Ketil Størdal
AU  - German Tapia
AU  - Lars C. Stene
PY  - 2026
DA  - 2026/08/28
JO  - Diabetologia
DO  - 10.1007/s00125-026-06832-0
UR  - https://doi.org/10.1007/s00125-026-06832-0
AB  - Aims/hypothesis: Environmental factors, including infections, have been suspected to influence the risk of type 1 diabetes. Studies of rotavirus vaccine and risk of type 1 diabetes have shown conflicting results. We took advantage of the rapid and high uptake of the rotavirus vaccine among infants in Norway as a natural experiment to study the potential association between rotavirus vaccination and type 1 diabetes incidence in Norway.  Methods: In this cohort study, we followed all children born in Norway during 2007–2019 from 6 months to 5 years of age for type 1 diabetes. In an interrupted time series analysis, we compared type 1 diabetes incidence in children born before compared with after introduction of the rotavirus vaccination programme in September 2014.  Results: Of 740,744 included children, 846 were diagnosed with type 1 diabetes between 6 months and 5 years of age. Our primary interrupted time series analysis showed an increasing trend after implementation of the rotavirus vaccination programme (relative HR 1.11 [95% CI 1.03, 1.20]), which was not significant after excluding birth cohorts from 2013–2015 to avoid potential herd immunity effects (relative HR 1.05 [95% CI 0.93, 1.18]). In a secondary analysis comparing fully vaccinated with non-vaccinated children, the adjusted HR was 1.17 (95% CI 0.78, 1.77).  Conclusions/Interpretation: This study found no evidence for a reduced risk of type 1 diabetes after introduction of rotavirus vaccination in infancy.  Graphical Abstract:  Supplementary Information: The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/s00125-026-06832-0.
SN  - 0012-186X
SN  - 1432-0428
ER  -