Spatiotemporal associations between incidence of type 1 diabetes and COVID-19 vaccination rates in children in Germany – a population-based ecological study.

Publication date: Sep 16, 2025

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. 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. 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. 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.

Semantics

Original Article