Live rotavirus vaccine linked to fewer pediatric celiac disease diagnoses

  • Hemming-Harlo M & al.
  • Pediatr Infect Dis J
  • 1 May 2019

  • International Clinical Digest
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Takeaway

  • In this large retrospective study of infants receiving live attenuated rotavirus vaccine vs placebo, having received vaccine was associated with lower incidence of celiac disease (CD).
  • Authors: “we propose that it is the intestinal damage associated with wild-type RV (rotavirus), but not RV infection as such, that triggers CD.”

Why this matters

  • Some evidence suggests RV could trigger type 1 diabetes (T1D) and/or CD because of molecular mimicry.
  • If it does, live attenuated oral RV vaccine could either have the same effect or, conversely, could be protective by preventing wild-type infection.

Key results

  • 5764 responded to questionnaire.
  • RotaTeq vs placebo groups:
    • T1D prevalence: 1.04% vs 0.97% (P=.810).  
    • CD prevalence: 0.60% (95% CI, 0.38%-0.93%) vs 1.11% (95% CI, 0.78%-1.6%; P=.027).

Study design

  • Retrospective analysis, randomized controlled double-blind REST trial plus Finnish Extension Study surveillance (n=5764).
  • In REST (2001-2003), participants randomly assigned to RotaTeq (Kenilworth, NJ) vaccine vs placebo.
  • In 2015, researchers sent questionnaire to parents of 19,133 Finnish Extension Study participants, asking about T1D, CD diagnoses.
  • Outcome: T1D and CD prevalence at time of questionnaire.
  • Funding: None disclosed.

Limitations

  • Apparent lack of vaccine effect on T1D could also be explained by its having similar effect to wild-type virus. 
  • Low questionnaire response rate.