Rotavirus Vaccination Does Not Increase Type 1 Diabetes and May Decrease Celiac Disease in Children and Adolescents

Pediatr Infect Dis J. 2019 May;38(5):539-541. doi: 10.1097/INF.0000000000002281.


Background: Rotavirus (RV) infection has been proposed to trigger type 1 diabetes mellitus (DM1) and celiac disease (CD) by molecular mimicry in genetically susceptible children. If so, a live attenuated oral RV vaccine could also trigger these autoimmune diseases, or else, prevent the effect of wild-type RV infection.

Methods: In Rotavirus Efficacy and Safety Trial, conducted between 2001 and 2003, the participant children received RotaTeq (Kenilworth, NJ) vaccine or placebo in 1:1 ratio. The surveillance was extended as Finnish Extension Study. A questionnaire was sent in 2015 to the parents of 19,133 Finnish Extension Study participants and 5764 (30%) returned the questionnaire. Diagnosis of DM1, biopsy-proven CD and other autoimmune disease over the 11-14 year period were inquired.

Results: At the time of questionnaire, the prevalence of DM1 was similar in both groups, 0.97% (25 of 2580 children) in the placebo group and 1.04% (33 of 3184 children) in the vaccine group (P = 0.810). The prevalence of CD was significantly higher in placebo recipients (1.11%; confidence interval: 0.78%-1.6%) than in vaccine recipients (0.60%; confidence interval: 0.38%-0.93%) (P = 0.027).

Conclusions: RV vaccination using RotaTeq did not alter the occurrence of DM1 but decreased the prevalence of CD in childhood and adolescence. We propose that wild-type RV may trigger CD and the triggering effect can be prevented or reduced by RV vaccination.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Celiac Disease / epidemiology*
  • Child
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Double-Blind Method
  • Female
  • Finland / epidemiology
  • Humans
  • Male
  • Placebos / administration & dosage
  • Prevalence
  • Rotavirus Infections / prevention & control*
  • Rotavirus Vaccines / administration & dosage
  • Rotavirus Vaccines / adverse effects*
  • Surveys and Questionnaires
  • Vaccines, Attenuated / administration & dosage
  • Vaccines, Attenuated / adverse effects


  • Placebos
  • RotaTeq
  • Rotavirus Vaccines
  • Vaccines, Attenuated