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78
Reference was made in the report for 1952, to the success of the publicity campaign
in checking the fall, experienced during previous years, in the number of children
immunised. Notwithstanding continued publicity and personal efforts by clinic doctors
and health visitors, the number of primary immunisations during 1953 again fell, and
the annual total was less than two-thirds of what it was in 1949. It is estimated that at
the end of 1953, the proportion of immunised children under 5 years of age had fallen
to its lowest level since the scheme came into full operation, namely 51.5 per cent.
For this situation the apathy of parents is largely to blame. The rarity of diphtheria
makes it difficult for parents to appreciate the potential danger of the disease, and to
this factor must be added fear of possible association with paralysis in poliomyelitis.
If the continuation of the present freedom from diphtheria is to be ensured, the number
of immunised children under five, and particularly under one, must be substantially
increased without delay, and no effort will be spared to achieve this object. Success
must however depend ultimately on the parents.
In September, 1953, the first batch of children to be fully documented under the
National Health Service Act, 1946, entered school. For this and subsequent groups it
is hoped to develop a close link between the routine school medical inspections, and
the checking of the children's immunisation state. ' Booster ' doses and if necessary,
primary immunisations will, subject to parential consent, be arranged. In this way a
considerable increase in the proportion of the school population immunised against
diphtheria may be achieved. To facilitate the transfer of details of the immunisation
history of each child, a combined infectious disease-immunisation record card will be
brought into use in child welfare centres, for transfer to school when the child reaches
the age of five.
47.7 per cent. of the children in the Council's residential establishments for children
in London were fully immunised at the end of 1953. Except for 2.2 per cent. in which
parental consent was refused, the remainder were awaiting either parental consent or
immunisation, or were unsuitable for immunisation. In out-country establishments,
77 per cent. of children had been immunised, and parental conscnt had been refused
for 2 per cent.
The following table indicates the number of children immunised against diphtheria
during the last five years :
1949 1950 1951 1952 1953
Total No. of Diphtheria Immunisations 57,929 47,605 40,339 42,958 36,004
Estimated percentage at end of year
of population 0-4 years who had at
any time been immunised against
diphtheria 54.7 554 53.7* 53.7* 51.5
*Corrected figure
Whooping cough immunisation
There is no scheme in London for immunisation against whooping cough corresponding
to that for diphtheria. Children may be immunised at the request of their parents by
arrangement at the Council's child welfare centres, and the Council pays the standard
fee of 5s. for records of such immunisation received from general medical practitioners.
Children may, if parents desire it, be immunised against both diphtheria and whooping
cough at the same time, by the use of a combined prophylactic. It is however, desirable
that a child should be protected against whooping cough before he reaches the age at
which the disease is most likely to be dangerous. This results in such children becoming
immunised against diphtheria at an earlier age than was formerly the case when immunisation
against the two diseases was performed separately. Combined immunisation
beginning at the age of about 4 months conforms to modern ideas on the subject. As
parental demand for whooping cough immunisation is greater than that for diphtheria