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parents wished them vaccinated against poliomyelitis was encouraged,
and 4,570 children in this Division were registered. The
amount of vaccine was very limited, however, and it was also
thought advisable to confine treatment to the months of May and
June, i.e. stopping it before poliomyelitis generally becomes prevalent.
As a result, only registered children born in certain months
were, in fact, called up for treatment, which was given only by
selected doctors of the Local Authorities.
In this Division 500 children each received two injections,
with a minimum interval of three weeks between the doses, and
hardly any immediate reaction was noted. Apart from that observation,
however, owing to the small number treated and the
comparatively low incidence of poliomyelitis in the Country in
1956, no reliable deductions as to its efficiency were reached.
COMBINATIONS OF VACCINE.
It will be seen from the above that the number of diseases
against which vaccines can be used has steadily increased, although
all have not been referred to in this Report, and also that a number
have only recently been introduced as suitable for general use.
Obviously the time has already come when the more they can
be given in combination, the fewer the injections and the less the
inconvenience to all concerned, with consequent greater popularity
and wider acceptance. Unfortunately, there are a number of resultant
problems which necessitate and are receiving considerable
time absorbing research, in particular the question as to what
extent combining various vaccines affects the efficiency of each.
Rapid progress along these lines cannot be expected.
Meanwhile the advice to parents has to be very carefully considered,
not only in the interests of the individual child but bearing
in mind the degree to which the advice will be acceptable as being
convenient to the parent.
At present the general use of anti-tuberculosis vaccination is
not anticipated, while vaccination against poliomyelitis is limited
by the quantity of vaccine becoming available. (At present this
form of vaccination is only given providing a minimum interval of
two or three weeks follows or precedes any other form of immunisation,
and that the child is otherwise fit and not likely to be incubating
any infectious disease).
Vaccination against smallpox can be given as early as two
months after birth in a healthy baby and, owing to the child's
comparative immobility, there are advantages in carrying out this
treatment as early as possible. Many think that it is wise to follow
this by a course of combined diphtheria, whooping cough and
tetanus prophylactics, commencing at the third month, particularly
in view of the relatively high number of deaths from whooping
cough in early infancy. On the other hand, there is evidence
against such an early start in diphtheria immunisation, while the
use of the triple vaccine may increase the risks of paralysis if and
when poliomyelitis is occurring in the vicinity.
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