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Environmental risk factors for type 1 diabetes remain unknown. It
has been speculated that some vaccines might trigger it, although data
are lacking. On p 1169 Karvonen et al describe their findings from a
nationwide randomised study on the association between
Haemophilus influenzae type b vaccination and type 1 diabetes in Finland, which has the highest incidence of type 1 diabetes. The risk of type 1 diabetes during the first 10 years of life was similar in children vaccinated with H influenzae
type b at 3 months and those immunised at 24 months only. Moreover, the incidence of the disease in the immunised children was no different from that in those children born during the two years before the start
of the vaccination programme. It is unlikely that H
influenzae vaccination causes type 1 diabetes in children.