Spatiotemporal associations between incidence of type 1 diabetes and COVID-19 vaccination rates in children in Germany: a population-based ecological study
Objectives The incidence of type 1 diabetes (T1D) in children increased during the first two years of the COVID-19 pandemic and declined thereafter. It is not known whether the decline is associated with COVID-19 vaccination rates in children. This study investigates whether COVID-19 vaccination rat...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
16. September 2025
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| In: |
The journal of pediatric endocrinology and metabolism
Year: 2025, Volume: 38, Issue: 11, Pages: 1117-1125 |
| ISSN: | 2191-0251 |
| DOI: | 10.1515/jpem-2025-0189 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1515/jpem-2025-0189 Verlag, kostenfrei, Volltext: https://www.degruyterbrill.com/document/doi/10.1515/jpem-2025-0189/html 
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| Author Notes: | Clemens Kamrath, Alexander J. Eckert, Sarah Lignitz, Nikolas Hillenbrand, Axel Dost, Katharina Warncke, Daniela Klose, Karina Grohmann-Held, Reinhard W. Holl and Joachim Rosenbauer |
| Summary: | Objectives The incidence of type 1 diabetes (T1D) in children increased during the first two years of the COVID-19 pandemic and declined thereafter. It is not known whether the decline is associated with COVID-19 vaccination rates in children. This study investigates whether COVID-19 vaccination rates are associated with T1D incidence in children. Methods Population-based ecological study of children with new-onset T1D in the years 2022 and 2023 from the German Prospective Diabetes Registry. COVID-19 vaccination rates (VR) for 2022 were obtained from the Digital Vaccination Rate Monitoring-Project of the Robert-Koch-Institute. Spatial Spearman correlation analysis between period-averaged COVID-19 VR and T1D standardized incidence ratios (SIR) per county were used for the year 2022. Bayesian conditional autoregressive (CAR) Poisson models, including a time lag of 0-12 months between COVID-19 VR and T1D SIR, were used to assess their association. Results Data of 6,736 children and adolescents with new-onset T1D in the years 2022 and 2023 and of 4,208,377 vaccinated children aged 5-17 years across 336 German counties were analyzed. Neither the month-averaged spatial analysis (5-11 years: r=−0.029 [95%CI −0.136; 0.079]; 12-17 years: r=0.031 [95%CI −0.077; 0.138]) nor the spatiotemporal CAR models including time shifts of 0-12 months showed significant correlations between T1D SIR and COVID-19 VR. Conclusions This study found no significant associations between childhood COVID-19 vaccination rates and the subsequent incidence of type 1 diabetes over the next 12 months. Further research is needed to investigate the relationship in younger children. |
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| Item Description: | Gesehen am 02.02.2026 |
| Physical Description: | Online Resource |
| ISSN: | 2191-0251 |
| DOI: | 10.1515/jpem-2025-0189 |