title: Vaccination and risk of type 1 diabetes mellitus in active component U.S. Military, 2002-2008.
abstract: OBJECTIVE
  To evaluate whether vaccination increases the risk of type 1 diabetes mellitus in active component U.S. military personnel.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Our 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)].
  
  
  CONCLUSIONS
  We 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.
authors.affiliation: Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, United States.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Duderstadt
authors.forename: Charles E
authors.initials: CE
authors.lastname: Rose
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Real
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Sabatier
authors.forename: Brock
authors.initials: B
authors.lastname: Stewart
authors.forename: Guihua
authors.initials: G
authors.lastname: Ma
authors.forename: Uma D
authors.initials: UD
authors.lastname: Yerubandi
authors.forename: Angelia A
authors.initials: AA
authors.lastname: Eick
authors.forename: Jerome I
authors.initials: JI
authors.lastname: Tokars
authors.forename: Michael M
authors.initials: MM
authors.lastname: McNeil
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008889:Military Personnel; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D014611:Vaccination / Q000009:adverse effects*; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014612:Vaccines