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New and not so new vaccines

BMJ 1996; 313 doi: (Published 28 September 1996) Cite this as: BMJ 1996;313:768
  1. Tom Jefferson, Coordinator
  1. Cochrane Vaccines Field, Ministry of Defence, Ash Vale, Hants GU12 5RR

    Let's think about evidence based policy making

    Calls are being made both at national1 and international2 level, to vaccinate whole populations against hepatitis B. Such exhortations are based on the fact that for the past 15 years safe and effective vaccines have been available to prevent the notable burden of morbidity and mortality from this global disease. But if uncritically accepted and extended to all new vaccines, this apparently humane logic could lead in the future to serious clashes between good intentions and resources. Some clear decision making principles are needed.

    Technological advances such as genetic engineering and the advent of monoclonal antibodies have led to an explosion in the number of vaccines currently being developed and tested, many of which may become available …

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