Suicide pacts and the internet

Abstract

convincing evidence that this has any implications for subsequent morbidity let alone mortality.If we had serious concern over such effects, the best way to evaluate them would be by large cluster randomised trials of different vaccine formulations, or of standard vaccines given according to different schedules.We could contemplate such trials for reasons of overall direct as well as indirect effects.The standard vaccines change over time, and the most widely used timetable (BCG/oral polio vaccine at birth, DTP/OPV at 6, 10, and 14 weeks of age, measles after 9 months) was set 30 years ago at the start of the World Health Organization's expanded programme on immunisation as an optimal compromise considering the vaccines then in use, the disease risks then prevailing, and logistic considerations concerning paediatric clinic policies for children of that era.But much has changed-new vaccines and vaccine formulations, lowered disease risks (largely due to widespread vaccination), and changed child health regimens, which now include micronutrients in many countries.We may need to reconsider the optimal basic schedule for delivery of vaccines and other services to the world's children, and we need to evaluate them if possible with trials-not with observational studies with biased data.

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