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(b) In L.C.C. Schools under the school medical service.
(c) Through private doctors in accordance with a scheme operated
by the Borough Council whereby prophylactic, i.e., alum
precipitated toxoid, is made available to medical practitioners
who receive payment in accordance with the approved scale
of the British Medical Association.
Sessions for immunisation are arranged from time to time in private
schools and in the war-time day nurseries. The Borough Council assumes
responsibility for post-Schick testing all children, including those
immunised in L.C.C. schools.
During 1944, 468 children were immunised under the arrangements
described above; of these 386 were of pre-school age and 82 attended
school. Comparative figures for 1943 and 1942 were 837 (616 of preschool
age ; 221 attending school) and 1,336 (743 of pre-school age and
593 attending school) respectively. While the results achieved during
1944 are not so satisfactory as those for the previous two years, it must
be remembered that during the latter half of 1944 large-scale evacuation
took place on account of flying-bombs and for five months the usual
weekly clinics were held at less frequent intervals.
It is difficult to estimate the percentage of pre-school children
immunised in the Borough as many of these are immunised privately
and a large number of temporarily evacuated children have been immunised
in reception areas. In schools reliable figures may be obtained
and at mid-1944 a survey conducted by the London County Council
indicated that 79.4 per cent. of Hampstead schoolchildren were
immunised, a percentage equalled by Westminster but excelled only by
the City of London (83.3 per cent.), where the school population was 502.
At the end of 1944, in a return to the Ministry of Health, I estimated the
percentages of children immunised as : pre-school children, 48 per cent. ;
schoolchildren, 75 per cent. In view of recent enquiries, it appears that
the percentage of pre-school children immunised is much higher, but it is
perfectly clear that if immunisation is to keep in line with the birth-rate
more than 1,000 children must be immunised in the Borough every year.
Three hundred and fourteen children were presented at clinics for
Schick testing after having received immunising injections ; in only two
cases did the test prove positive and necessitate further inoculations.
Two children under 15 years of age were notified as suffering from
diphtheria during 1944 ; both were not immunised. Comparative figures
for 1943 and 1942 are 3 and 10 children respectively, all non-immunised.
A recent Ministry of Health Circular (No. 170/44, dated the 4th
December, 1944) has stated : " It is of interest also to note, even though
no causal connection can be positively demonstrated, that a decline in the
number of deaths from diphtheria, from 2,480 in 1940 and 2,641 in 1941
to 1,827 in 1942 and 1,370 in 1943, has coincided with an increasing
proportion of children protected by immunisation." The local experience
is indicated in the remarkable statistics relating to Hampstead as given
below. (It should be noted that free immunisation was commenced in
the Borough in mid-1933 ; since that time 5,418 children have been
immunised under official arrangements.)