View report page

IMMUNISATION AND VACCINATION
Vaccination against smallpox had been a function of the metropolitan borough councils
before 5 July 1948 but on that day the Public Vaccinator and the Vaccination Officer,
who had for many years been responsible for carrying out the provisions of the Vaccination
Acts, disappeared from the scene. Thereafter compulsion was replaced by persuasion and
in London this resulted in a steady increase in the acceptance rate of infant vaccination.
In twelve years the acceptance rate rose to about double its previous level. From 1963
onwards, largely as a result of altering the age for vaccination to 18 months of age, the
acceptance rate fell considerably and it is still uncertain whether it will be possible to
restore it to its previous level.
The rate of diphtheria immunisation fell for a few years from 1949 onwards, following
reports of provocation poliomyelitis following inoculations and the uncertainty resulting
therefrom. This fall was not as great as that occurring in some areas because, although
alum-containing prophylactics were discontinued at that time, it was decided to continue
using combined and triple prophylactics not containing alum. A considerable improvement
in the rate of primary immunisation against diphtheria occurred following the introduction
of a standard schedule of immunisation in 1959. The virtual abolition of diphtheria since
the beginning of the immunisation campaign is now a matter of history.
The result of many years of infant vaccination against whooping cough is now becoming
apparent in the very marked reduction in incidence of this disease in recent years.
Since 1959 the routine infant course of vaccinations has included three injections of
tetanus toxoid. The object of this course is to try to reduce the necessity to give an injection
of horse serum to injured persons. The fact that by now most of the children in London
under the age of five years have had a course of active immunisation against tetanus must
in time affect the routine of treatment in the hospital accident departments.
Inoculation against poliomyelitis began on a small scale in 1956, being restricted at
first to children born from 1947 to 1954. It was extended in 1957 to young people aged
under 16 years, expectant mothers and other priority groups and was further extended in
1958 to everyone under the age of 40 years. British Salk-type vaccine was used from the
early years but Sabin (oral) vaccine was available from early in 1962. Salk vaccine reduced
the incidence of the disease but had no effect on the carrier rate in the population. The
introduction of Sabin vaccine, by inducing intestinal immunity, produced the virtual
elimination of carriers of pathogenic poliomyelitis virus from the community, with consequent
benefit to immunised and unimmunised alike. In 1964 there was only one notification
of poliomyelitis in London.
At the invitation of the Ministry of Health, a yellow fever vaccination service has been
provided by the Council since 1960. This is operated by arrangement with the authorities
of the centres shown in table (v) who give vaccination and issue the appropriate international
certificates. No charge is made to the public for this service.