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To the Editor We read with interest the Research Letter of Perrett et al on the association of rotavirus vaccination with the incidence of type 1 diabetes (T1D) in children in Australia. Comparing the observed or model-based incidence of T1D before and after the introduction of the oral rotavirus vaccination to the Australian National Immunisation Program in 2007, Perrett et al provided evidence that the incidence of T1D in the age group 0 to 4 years has declined by 14% after the introduction of routine rotavirus immunization, while there was observed no change in children aged 5 to 14 years. However, it cannot be excluded that the observed association may represent a spurious correlation owing to an ecologic fallacy.
To the Editor We read with interest the article by Perrett et al published in JAMA Pediatrics, which used interrupted time-series analysis to study the association of rotavirus (RV) vaccination with incident type 1 diabetes (T1D) in Australia. We believe that given the data presented, the decline in T1D incidence after vaccine introduction is not consistent with the hypothesis that RV vaccine may be protective against T1D development. Rather, the abrupt decrease in incidence around the time of RV vaccine introduction suggests that an alternative cause should be sought.
To the Editor We write to report a coding error that affected the reported type 1 diabetes (T1D) rates but not the overall findings in our Research Letter titled, "Association of Rotavirus Vaccination With the Incidence of Type 1 Diabetes in Children," published online January 22, 2019, and in the March 2019 issue of JAMA Pediatrics.
In Reply We thank Rosenbauer et al and Vajravelu et al for their comments on our Research Letter. Rosenbauer et al requested more details of the statistical methods. We used an interrupted time-series analysis (ITS) on the incidence of newly diagnosed type 1 diabetes (T1D) in children aged 8 years before and after the May 2007 introduction of routine infant oral rotavirus (RV) vaccination. Counts of new T1D cases by age were modeled as Poisson random variables. Publicly available population data for each age group and sex combination in each year were included as an offset in the model, and inference was on the relative change in incidence rates averaged over the preperiod and postperiod.
Children, adolescents, and young adults living with life-threatening serious pediatric illness (SPI) face considerable physical and emotional tolls via their disease conditions, treatment demands, and sequelae. To guide clinical interventions and future research for young people with SPI, Barker and colleagues conducted a meta-analysis to estimate the prevalence of anxiety and depression in children and young people with a variety of SPI, including cancer, cystic fibrosis, HIV, thalassemia, neurological conditions, and chronic kidney disease. The authors found that the prevalence of anxiety and depression is higher among youth with SPI compared with the general youth population. Specifically, the pooled prevalence was 19.1% (range, 3.6%-58.
In the Clinical Guideline Synopsis titled “Management of Pediatric Gastroesophageal Reflux Disease,” published online March 18, 2019, and in the May print issue, there was an error in the text. In the paragraph with the subhead “Formula Thickeners,” the last sentence should read, “Commercial thickeners (eg, xanthum gum, carob bean, alginate) should be used with caution as reported complications include necrotizing enterocolitis and bowel obstruction.” This article was corrected online.
To the Editor A research article published in JAMA Pediatrics, "Associations of Maternal Diabetes and Body Mass Index With Offspring Birth Weight and Prematurity," asserts that maternal insulin-treated diabetes and obesity in mothers with type 2 diabetes appeared to be associated with increased risks for the offspring being large for gestational age (LGA) and preterm births.
In Reply We appreciate the wide interest in our research article regarding the prevalence and treatment patterns of autism spectrum disorder (ASD) among children in the United States. Based on data from the 2016 National Survey of Children’s Health (NSCH), we estimated that the prevalence of ever-diagnosed ASD and current ASD was 2.79% and 2.50%, respectively. Among children with current ASD, almost 30% did not receive either behavioral or medication treatment. An independent analysis by Kogan et al has yielded virtually identical results, affirming the overall robustness of the national-level estimates in our study.
In the article titled “Association of Increased Safe Household Firearm Storage With Firearm Suicide and Unintentional Death Among US Youths,” reference 34 was unnecessarily included on initial publication and has been deleted. A small revision in the Conclusions was also made. In the first sentence, “the evidence characterizing existing interventions” has been updated to “mixed.”

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