Type 1 diabetes, COVID-19 vaccines and short-term safety: Subgroup analysis from the global COVAD study

J Diabetes Investig. 2024 Jan;15(1):131-138. doi: 10.1111/jdi.14079. Epub 2023 Sep 11.


Aims/introduction: Coronavirus disease 2019 (COVID-19) vaccinations have been proven to be generally safe in healthy populations. However, the data on vaccine safety in patients with type 1 diabetes are scarce. This study aimed to evaluate the frequency and severity of short-term (<7-day) adverse vaccination events (AEs) and their risk factors among type 1 diabetes patients.

Materials and methods: This study analyzed data from the COVID-19 vaccination in Autoimmune Diseases (COVAD) survey database (May to December 2021; 110 collaborators, 94 countries), comparing <7-day COVID-19 vaccine AE among type 1 diabetes patients and healthy controls (HCs). Descriptive statistics; propensity score matching (1:4) using the variables age, sex and ethnicity; and multivariate analyses were carried out.

Results: This study analyzed 5,480 completed survey responses. Of all responses, 5,408 were HCs, 72 were type 1 diabetes patients (43 females, 48.0% white European ancestry) and Pfizer was the most administered vaccine (39%). A total of 4,052 (73.9%) respondents had received two vaccine doses. Patients with type 1 diabetes had a comparable risk of injection site pain, minor and major vaccine AEs, as well as associated hospitalizations to HCs. However, type 1 diabetes patients had a higher risk of severe rashes (3% vs 0.4%, OR 8.0, 95% confidence interval 1.7-36), P = 0.007), although reassuringly, these were rare (n = 2 among type 1 diabetes patients).

Conclusions: COVID-19 vaccination was safe and well tolerated in patients with type 1 diabetes with similar AE profiles compared with HCs, although severe rashes were more common in type 1 diabetes patients.

Keywords: COVID-19; Type 1 diabetes mellitus; Vaccine.

MeSH terms

  • Autoimmune Diseases*
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Female
  • Humans
  • Pathologic Complete Response
  • Risk Factors


  • COVID-19 Vaccines