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

Aims/hypothesisTo evaluate whether vaccination increases the risk of type 1 diabetes mellitus in active component U.S. military personnel.MethodsWe 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.ResultsOur 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)].ConclusionsWe 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.

► We evaluated the risk of type 1 diabetes mellitus after vaccination in U.S. military personnel.
► We conducted a cohort study among active component U.S. military personnel age 17–35 years.
► We did not find increased risk of diagnosed type 1 diabetes for any of the study vaccines.
► Our study findings are reassuring for the safety of the study vaccines in this military population.