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Although a written invitation is issued personally by health
visitors to the parents on a visit to the parental home shortly after
the birth of the child, and despite a continuous programme of health
education which includes personal persuasion by health visitors in
their day-to-day contact with families, and written reminders, the
number of completed primary courses of immunisation is lower than the
drop in the number of live births would lead one to expect. The low
number of completed primary courses is not due entirely to parental
apathy.
Population movement is of importance. The Annual Abstract of
Greater London statistics shows that, in 1966, about twenty per cent
of the population of this borough had been living outside the borough
a year previously, and more than thirty per cent five years before.
The converse is true and this is particularly the case with young
families.
Inquiry into the reasons for this exodus from Kensington and
Chelsea has shown that, whilst many young childless married couples
make their first homes in the borough, once a child is born they
move out of the borough to areas where family accommodation is
easier to obtain. These "first-child" families are replaced, in the
main, by childless couples or single people, and the process is
continuous. Thus, the ratio of children aged 0-5 years immunised
to the number of children born to parents living in Kensington and
Chelsea appears to be disproportionately low compared with other
areas where housing accommodation is more suited to "moderate income"
family life. The population in the age group referred to in such
areas tends to be more static, resulting in a situation which should
encourage a higher ratio of immunisations of children aged 0-5 years
to the number of children born than it is possible to expect in this
borough under present circumstances. The high illegitimate birth
rate is a contributory factor, as many of these children are placed
direct for adoption outside the borough. The number of children
moving into the borough is not enough to offset the number moving out.
The effect of migration on this situation was that of the
corrected number of live births in 1965 (3,666), 1,152 children
moved from the borough during 1965/66, and 84 deaths occurred under
one year; against this, 258 children moved into the borough during
the same period. This resulted in a potential 2,688 children for
complete courses of immunisation. On this basis, the percentage for
completed courses in 1965 and 1966 of children born in 1965 and
resident in the borough when the course was completed were:-
Whooping cough 81.5
Diphtheria 91.0
Poliomyelitis 75.2
Smallpox 47.5
Of children notified as being born in the borough in the year
1966, approximately twenty per cent had moved out within five
months of birth.