Vaccination and risk of type 1 diabetes mellitus in active component U.S. Military, 2002-2008

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• 作者：Susan K. Duderstadt^a ; ^d ; Charles E. Rose Jr^b ; Theresa M. Real^a ; ^d ; Jennifer F. Sabatier^c ; Brock Stewart^a ; ^e ; Guihua Ma^a ; ^d ; Uma D. Yerubandi^a ; ^d ; Angelia A. Eick^f ; Jerome I. Tokars^a ; Michael M. McNeil^a ; ^mmm2@cdc.gov
• 关键词：Type 1 diabetes mellitus ; Adult vaccination ; Vaccine safety
• 刊名：Vaccine
• 出版年：2012
• 出版时间：17 January 2012
• 年：2012
• 卷：30
• 期：4
• 页码：813-819
• 全文大小：241 K

文摘

Aims/hypothesis

To evaluate whether vaccination increases the risk of type 1 diabetes mellitus in active component U.S. military personnel.

Methods

We conducted a retrospective cohort study among active component U.S. military personnel age 17-35 years. Individuals with first time diagnoses of type 1 diabetes between January 1, 2002 and December 31, 2008 were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We used Poisson regression to estimate risk ratios between individual vaccine exposures and type 1 diabetes. Secondary analyses were performed controlling for receipt of multiple vaccines and available demographic variables.

Results

Our study population consisted of 2,385,102 individuals followed for approximately 7,644,098 person-years of service. This included 1074 incident type 1 diabetes cases. We observed no significant increased risk of type 1 diabetes after vaccination with anthrax vaccine adsorbed (AVA) [RR = 1.00; 95 % CI (0.85, 1.17)], smallpox vaccine [RR = 0.84; 95 % (CI 0.70, 1.01)], typhoid vaccine [RR = 1.03; 95 % CI (0.87, 1.22)], hepatitis B vaccine [RR = 0.83; 95 % CI (0.72, 0.95)], measles mumps rubella vaccine (MMR) [RR = 0.71, 95 % CI (0.61, 0.83)], or yellow fever vaccine [RR = 0.70; 95 % CI (0.59, 0.82)].

Conclusions

We did not find an increased risk of diagnosed type 1 diabetes and any of the study vaccines. We recommend that follow-up studies using medical record review to confirm case status should be considered to corroborate these findings.