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(3) Material for immunisation to be supplied from my
Department to general practitioners on application.
The application would state the name, age and address
of the child to be immunised.
(4) The antigen of choice to be T.A.F. (referred to earlier
in this report).
(5) Remuneration to be 7/6d. per completed case, i.e., 2/6d.
per injection.
(6) Age category of cases to remain as at present, i.e., 1 to
to 14 years. Special emphasis to be laid on the necessity
for children under 5 to be immunised.
I feel that a scheme based on the foregoing principles would
function well and should not prove difficult to administer. The
financial outlay would be in the region of 12/6d. to 15/- per case
to commence with, but should decrease later for the following
reasons :—
a. With increase in numbers desiring immunisation, the
cost of material would be less.
b. Probably within the next year it will be possible to
recommend the adoption of material needing one or at
most two injections. This will substantially reduce the
cost of material and the payment to practitioners.
c. It is possible that experience will show that the confirmatory
Schick test is not essential.
In any case, there is such a degree of safety attached to a
successful immunisation that I suggest financial considerations
should be of secondary importance.
To complete my report, and as a final statement as to the
efficacy of Diphtheria Immunisation, I submit the following
up-to-date figures relative to the Birmingham scheme, supplied
to me through the courtesy of Dr. Vera Followes of the Diphtheria
Prevention Clinic.
From 1925 to the end of June 1937, 93,000 children between
the ages of 8 months and 15 years have been innoculated against
Diphtheria. Of this number 62 developed Diphtheria notwithstanding
the innoculation, but no deaths occurred. Among the
non-immunised children during the same period, 13,486 cases
occurred with 857 deaths. The estimated child population of
the City is 250,000 and at present some 15,000 children are being
immunised each year.
There is overwhelming evidence here in favour of immunisation,
and the same experience is found in many other places in
this country and abroad.