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Review
. 2016 Feb;59(2):237-43.
doi: 10.1007/s00125-015-3800-8. Epub 2015 Nov 12.

Vaccinations and childhood type 1 diabetes mellitus: a meta-analysis of observational studies

Eileen Morgan  1   2 , Sophia R Halliday  1   3 , Gemma R Campbell  2 , Chris R Cardwell  2 , Chris C Patterson  4   5
Affiliations
Free PMC article
Review

Vaccinations and childhood type 1 diabetes mellitus: a meta-analysis of observational studies

Eileen Morgan et al. Diabetologia. 2016 Feb.
Free PMC article

Abstract

Aims/hypothesis: The aim of this study was to investigate the association between routine vaccinations and the risk of childhood type 1 diabetes mellitus by systematically reviewing the published literature and performing meta-analyses where possible.

Methods: A comprehensive literature search was performed of MEDLINE and EMBASE to identify all studies that compared vaccination rates in children who subsequently developed type 1 diabetes mellitus and in control children. ORs and 95% CIs were obtained from published reports or derived from individual patient data and then combined using a random effects meta-analysis.

Results: In total, 23 studies investigating 16 vaccinations met the inclusion criteria. Eleven of these contributed to meta-analyses which included data from between 359 and 11,828 childhood diabetes cases. Overall, there was no evidence to suggest an association between any of the childhood vaccinations investigated and type 1 diabetes mellitus. The pooled ORs ranged from 0.58 (95% CI 0.24, 1.40) for the measles, mumps and rubella (MMR) vaccination in five studies up to 1.04 (95% CI 0.94, 1.14) for the haemophilus influenza B (HiB) vaccination in 11 studies. Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with high methodology quality scores. Neither this restriction by quality nor the original authors' adjustments for potential confounding made a substantial difference to the pooled ORs.

Conclusions/interpretation: This study provides no evidence of an association between routine vaccinations and childhood type 1 diabetes.

Keywords: Epidemiology; Meta-analysis; Type 1 diabetes; Vaccinations.

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Conflict of interest statement

Funding During the period of this study, EM was a PhD candidate at Queen's University Belfast funded by the Centre of Excellence for Public Health (Northern Ireland), a UKCRC Public Health Research Centre of Excellence (grant number RES-590-28-0001). Duality of interest The authors declare that there is no duality of interest associated with this manuscript. Contribution statement EM, SRH and GRC independently reviewed the studies from the searches. CCP contributed to discussion about the final set of studies to be included in the review. EM, SRH and GRC extracted the necessary data from the final studies. EM, CCP, CRC, GRC and SRH contributed to the analyses and interpretation of the data and drafted and revised the manuscript. All authors commented on and revised the manuscript. All authors gave final approval to the published version of this paper. CCP is the guarantor of this work.

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