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71
What of the Future?
The aim of everyone who takes up the work must be to get all the children living
in the area immunised as soon as possible after they reach the age of 6 months. In
Holborn we have not reached this stage yet; the history of vaccination against small
pox suggests we never shall. But a local health authority is justified in considering
that it has done all in its power to prevent loss of life and illness from diphtheria if it
offers immunisation, supported by necessary advice and information to parents.
It might be expected that if the immunisation were carried out among the
school population in a large town the parents would come to regard the procedure
as more ordinary, and be prepared to allow the younger children to be immunised
at infant welfare centres. Apparently it cannot be too often repeated that it is
immunisation at a very early age that we want carried out; if it is delayed till
school age half the deaths will have occurred. In London during five years
1923-27, of the total deaths from diphtheria,59 per cent. occurred under five years
of age.
If the immunisation could be completed at one visit the energy spent in
looking up those failing to attend could be used in getting new recruits, and the
parents would be spared much trouble.
The decision of the London County Council not yet to take up the matter of
diphtheria immunisation in the schools though willing to help the work started in
the various boroughs, by affording facility in the schools for the circularisation of
information to parents, was somewhat of a disappointment to several Medical
Officers of Health of Metropolitan Boroughs. Where a Borough Council has
definitely decided in favour of diphtheria immunisation and offers it to children
under five years of age, each voung child is brought to the Immunisation Centre as
a result of individual effort, but the organisation of a public elementary school
lends itself so easily to the mass immunisation of a large body of children that it
seems very unfortunate that the Borough who has approved the principle should
lose this advantage.
It should be pointed out that the results obtained in Holborn from antidiphtheria
immunisation are not necessarily those which would be obtained from
the widespread practice of the procedure throughout the whole of the country. It