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IMMUNISATION AND VACCINATION
Diphtheria, tetanus, whooping cough—

* Started January, 1957.
The number of children referred to in table (i) who received multiple antigens is as
follows:

The year 1960 was the first full year in which all divisions were operating the standard
schedule of immunisation introduced in 1959 and referred to in detail in my report for
that year (page 73).
It will be seen that the number of children given a primary course of immunisation
against diphtheria, whooping cough and tetanus showed a distinct increase over the figures
registered in 1959. In fact the number of infants immunised was higher than in any year
since the National Health Service came into being. Unfortunately, the same cannot be
said about smallpox vaccination, the figures for which showed a reduction compared with
1959 (table (iii)). A reduction was not unexpected, in view of the fact that smallpox vaccination
was put back from its former position of the first immunising procedure to be given
to the child to its present position between the triple vaccine and the poliomyelitis vaccine;
but this does not completely explain the very marked drop in the vaccination rate and
steps are being taken to improve this figure in 1961.
Some children do not begin their immunisation at the correct time and advice was given
to divisional medical officers on modifications to the schedule appropriate to various ages.
The modifications depend upon the fact that as the child grows older the urgency of
whooping cough protection grows less and that of poliomyelitis vaccination greater.
Thus from the age of seven months onwards poliomyelitis vaccination will precede the
course of triple vaccine.
The personal record card introduced in 1959 continued in use and has proved a popular
innovation. It is used to introduce the subject of immunisation to mothers and thereafter
as an appointment card and a personal record of immunisation.
During the year new sterilisation arrangements were brought into operation. Enough
syringes and needles were supplied to provide for each child a separate syringe and needle
to be boiled for 20 minutes in a single well-supervised operation before the immunisation
session began. Quick re-boiling, with the possibility of insufficient sterilisation, was thus
no longer necessary. A separate syringe and needle are now used generally throughout
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