Impact of Rotavirus Vaccination on Type 1 Diabetes Incidence among Children?Machine-Learning?Based Analysis

초록

Introduction and Objective: Type 1 diabetes (T1D) is an autoimmune disease characterized by pancreatic islet β-cell destruction, with environmental factors such as rotavirus (RV) infections implicated as potential triggers through molecular mimicry. Observational studies in Australia and other countries have suggested a decline in T1D incidence following the introduction of RV vaccination. This study investigates the association between RV vaccination rates and T1D incidence in Korean children under 14 and predicts future trends under a hypothetical 100% RV vaccination rate using machine learning. Methods: Using National Health Insurance Service (NHIS) data (2002-2019), we analyzed T1D incidence and RV vaccination rates among children aged 0 to 14 in Korea. T1D patients were identified using ICD code E10 and insulin prescription data. Incidence rates were calculated annually, and changes in T1D incidence before and after RV vaccine introduction in 2007 were evaluated. Machine learning models, including time-series forecasting and regression models, were applied to predict T1D incidence rates under a 100% vaccination scenario from 2020 to 2050. Results: The introduction of RV vaccination in 2007 coincided with a slight decrease in T1D incidence rates, particularly in younger age groups. Machine learning models projected a gradual decline in T1D incidence under a sustained 100% RV vaccination rate, reflecting a potential long-term benefit. Conclusion: This study highlights the potential non-infectious benefits of RV vaccination in reducing T1D incidence among children. Widespread RV vaccination could significantly alleviate healthcare and societal burdens associated with T1D. Despite challenges related to the dynamic nature of the cohort and the limited intervention period, these findings emphasize the importance of comprehensive vaccination programs in public health strategies.