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43
to be an over-statement, because these records are based upon verbal assurances
from parents without the production of a certificate of completed immunisation, and
there are probably many affirmative answers given when, in fact, immunisation has
not been completed. Probably the truth is intermediate between the two limits
and it is felt that an estimate that, say, 75 per cent. of school entrants have been
immunised is not likely to be greatly in error.
In discussing immunisation statistics, the Registrar-General states (Statistical
Review, 1940-1945, Text Vol. I (Medical)): "If 47,000 children of those ages (5-15)
had returned to London after being immunised in reception areas without their
transfer being recorded in the returns, the London percentages (immunised) would
be raised to equality with the English County Boroughs." At the end of 1945 the
county borough percentage was 72 at school ages. At that time it had been estimated
after comparing Borough and School records that the corresponding percentage in
London was 70 and it now appears that this was reasonable.
The division of cases between immunised and unimmunised children when the
relative sizes of the two populations are taken into account indicates that the attack
rate in the "protected" population was only about 13 per cent. of that in the "unprotected,"
and judged from the absence of deaths, the incidence in the "protected"
population was restricted to mild cases. Comment on the role of immunisation in
accelerating the fall in the incidence of diphtheria in London is given in the Vital
Statistics Section of this report (p. 14). In London the notification rate 0-4 has
fallen from 5.88 per thousand in 1938 to 0.38 per thousand in 1948. The rate at
ages 5-14 has fallen from 4.43 to 0.39. In 1938 there were 205 deaths of all ages,
and in 1948 only 19.
Active immunisation against diphtheria was continued at the Council's residential
establishments for children. At the end of the year, 89 per cent. of the children
in residence had been, or were in process of being, immunised. Of the remainder, in
the majority of cases, parental consent had not been received.
Vaccination
The Council assumed responsibility on the 5th July for the vaccination against
smallpox of persons in its administrative area, and made arrangements for vaccination
sessions to be held at welfare centres, etc., and for vaccination to be carried out by
general practitioners in the county who wished to perform this service on its behalf.
Where vaccination is carried out by general practitioners, a fee is paid by the
Council to the practitioner for completing the record of vaccination, as in the case
of immunisation against diphtheria. The lymph is supplied free of charge to the
Council by the Ministry of Health through their Public Health Laboratory Service.
General practitioners are also able to obtain supplies from the same source. The
following tables give particulars of the number of persons who were vaccinated
under these two arrangements:—
Residential
establishments