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In 1948 the arrangements for vaccination and immunisation in the metropolitan
boroughs although having a basic similarity, showed wide variations in detail. It was
the Council's expressed intention at the time the National Health Service came into
operation to continue in the main the existing arrangements, expanding them and
developing them where necessary. The initial variations found in different areas and the
fact that divisional medical officers have favoured different methods in the medical and
administrative approach to the subject, are responsible for the fact that even today
there are some differences in immunisation practice in different parts of the County.
This is as it should be in a field which has seen many changes in recent years and in which
finality has not yet been reached. It has allowed scope for local trials of particular
methods of immunisation (such as the Medical Research Council trials of combined
immunisation in division 9, and the various researches carried out by Dr. Guy Bousfield
on the use of new prophylactics) and of different methods of organisation and administration.
The end of
compulsory
vaccination
The end of the era of compulsory vaccination saw the beginning in London of a
period in which there was a substantial improvement in the level of infant vaccination.
The figures giving the relation between the number of vaccinations in children under
the age of one year and the number of live births in each year have been as follows :
Year
Percentage
of live
births
1949
1950
1951
1952
1953
1954
1955
1956
1957
25
31
38
45
48
49
50
49
56
The present level of infant vaccination is substantially higher than the level achieved
during the later years of the Vaccination Acts, a fact which vindicates the expectations
of those responsible for repealing the Acts. It will be seen that most of the improvement
took place during the first five years of the period and that in the last few years performance
has been fairly level from year to year. The considerable increases seen in each
of the years 1950-1953 are probably not unassociated with the fact that each of these
years was marked by the occurrence of cases of smallpox in this country, attention
thereby being focused periodically on vaccination as a preventive measure. It is noteworthy
that habits of thought and action acquired during these years appear to be still
in operation in maintaining a continuous comparatively high level of infant vaccination
in recent years.
In the Council's scheme for bringing about the highest possible level of infant
vaccination and immunisation against diphtheria the principal reliance is placed upon
the health visitor. It is part of her routine duty to educate mothers to accept these
preventive methods as part of normal child care and to ensure that the parents bring
the children forward for vaccination and immunisation at the proper times. This work
of education is carried out by health visitors both in the child welfare centres and on
their visits to mothers and children in their own homes. The personal appeal to parents
is reinforced in various ways. Once a year a publicity campaign is carried out on the
subject of diphtheria immunisation. During a period of a fortnight posters are exhibited,
advertisements are inserted in local newspapers, short films are shown in cinemas, talks
are given and leaflets distributed. Such publicity drives are regarded as adjuncts and
never as substitutes for the personal approach by health visitors to the parents. In some
districts a card is sent out to the parent on the child's first birthday stressing the importance
of certain health matters including immunisation.
The personal
approach to
parents
67
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