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9
In 1949 a relationship between recent inoculation and the
subsequent onset of paralysis in the inoculated limb was established.
A similar relationship apparently exists between tonsillectomy,
minor traumata and paralysis. Early in the year a form was
devised to elicit as much information as possible from reported
cases and contacts. Enquiry was made regarding recent inoculations,
operations, minor ailments and illnesses of contacts and a
list of all known cases in the Borough was shown to the household
with a view to determining any link, however tenuous. The results
of our enquiry are summarised in the table to which I have referred
previously. But in only one case was there a possible connection
between recent inoculation and the onset of paralysis in the inoculated
limb. Information regarding this case was passed to the
Ministry of Health.
In July, the County Council saw fit to impose a ban on combined
whooping-cough and diphtheria prophylactic and the A.P.T.
diphtheria prophylactic was replaced by P.T.A.P. and subsequently
by Formol Toxoid. No further whooping-cough vaccine was used
for the remainder of the year. I wonder if the incidence and the
evidence warranted such cessation. I am well aware of the cogent
arguments advanced in support of the action. I know that the
efficacy of the whooping-cough vaccine is disputed, but was not this
a case of allowing sentiment to overcome what should be strict
objectivity?
Poliomyelitis is a distressing disease but no one has ever suggested
that as a social problem in its present form it can ever be as
serious as whooping-cough or diphtheria. Even in epidemic areas
of the world it has never reached the degree of infectivity non the
potential morbidity of whooping-cough or diphtheria.
I believe, with some evidence to support the belief, that while
whooping-cough vaccine may not possess the immunising properties
of the highly-refined diphtheria prophylactics, it does mitigate an
attack if it does not wholly protect the child and any complications
which may ensuo are minimal. This is an important protective measure
which should not be discarded lightly, and having studied the
available evidence to date 1 am not satisfied that whooping-cough
vaccine or the combined whooping-cough and diphtheria antigen
can be indicted any more than Other inoculation or vaccination
procedure. The very comprehensive survey of Bradford Hill
which appeared in the British Medical Journal and which covered
all known cases in the country of paralysis associated with inoculation,
would seem to support this contention.
I do not dispute the desirability of obtaining a more potent and
reliable method of whooping-cough immunisation and one which