Impact of vaccination on the development of type 1 diabetes in children and vaccine safety in pediatric patients with T1DM: A systematic review.

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease associated with increased susceptibility to infections, making immunization an important component of pediatric diabetes care. Despite the established benefits of vaccination, concerns persist regarding its potential role in triggering autoimmune diseases, including T1DM. This systematic review evaluated the impact of vaccination on the risk of developing T1DM in children and assessed vaccine safety in those with established disease. PubMed and Embase were searched for studies published between 2015 and 2025 in accordance with PRISMA 2020 guidelines. Twenty-one original studies met the eligibility criteria. For three rotavirus cohort studies reporting directly comparable adjusted hazard ratios (HRs) for subsequent T1DM, an exploratory inverse-variance random-effects meta-analysis was performed. Overall, the available evidence showed no increased risk of T1DM associated with vaccination. Five studies suggested possible protective effects of rotavirus or BCG vaccination against T1DM development. Influenza and SARS-CoV-2 vaccines were safe in children with established T1DM, with adverse events predominantly mild and transient. Some studies also reported reduced hospitalization rates and fewer infectious complications among vaccinated individuals. Current evidence strongly supports routine childhood vaccination and indicates that immunization is safe and may provide additional benefits for children with or at risk of T1DM.