London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Kensington 1943
[Report of the Medical Officer of Health for Kensington Borough]
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Diphtheria Immunisation. The following table shows the diphtheria immunisation work carried out during the year:-
| No. of pre-school children immunised | 979 |
| No. of school children immunised | 595 |
| Total no. of children attending for pre-immunisation schick tests | 697 |
| No. which gave positive reaction | |
| No. of children presented for schick testing after having received immunising innoculations | 662 |
| No. proving negative | 2,155 |
| No. proving positive | 363 |
| No. who failed to attend for readings | 144 |
During the ten years 1934 to 1943 inclusive,
13,348 children resident in the Borough have been immunised
against diphtheria or found by Schick test to be naturally
immune to the disease. In this same period 68 deaths due
to diphtheria occurred, but in no case has death occurred
in a child who had been immunised.
In 1943 fifty-four cases of diphtheria were
notified and,of these, four had been previously immunised.
None of the immunised cases was severe and all yielded
readily to treatment. Further analysis of these four
cases showed that two of the children had not had a postschick
test so that it cannot be certain that the immunisation
was complete, and in the other two cases, the immunisation
process had been completed seven years previously
Rather more than 60% of children now resident in the borough
have been immunised, so it will, therefore, be seen that
fifty cases occurred amongst 40% non-immunised, and only
four in the 60% who had been immunised. Thus it will be
seen that the chances of a non-immunised child contracting
the disease are many times greater than those of an immunised
child. Moreover, the illness is almost invariably less
severe in the immunised child, and there is no record in
this borough of a death from diphtheria of an immunised
child.
A number of children who had been immunised
some years previously have had further schick tests
in 1943, and the results show that immunisation is not always
permanent. Although the number of cases so far retested
is relatively small, it is probably safe to say that
after an interval of five years, between 10% and 15% have
lost part of their immunity.
During the past year, therefore, a Schick test
has been advised in the case of all "school entrants" who
had been previously immunised, and other school children
who had been immunised some years before, and in all cases
where a positive result was obtained, further immunisation
was given. It is hoped that by this means even the small
number of cases of diphtheria which may occur among immunised
children will be prevented.