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38
IMMUNISATION
Last year I reported to the County Borough Health Committee
on the adoption of a new schedule for the timing of the various
procedures now available for protection against Poliomyelitis,
Whooping Cough, Diphtheria, Tetanus, Smallpox and Tuberculosis.
The expert advisory committee which drew up schedules for the
Ministry of Health recommended local authorities to select one
of two programmes. The first was based on the supposed need to
protect very young infants against whooping cough, and began
with injections of triple vaccine as soon as possible after the
baby reaches one month of age. The second had regard to the age
at which the child will respond best to a minimum of injections,
discounts the early risk from whooping cough, and commences with
oral poliomyelitis vaccine at 6 months of age. Of recent years
whooping cough in Croydon (and Surrey) has been mild in character
with negligible mortality. Whooping cough vaccine is a
relatively crude antigen, producing local or general reactions
in half the children injected and I have always been reluctant
to suggest its use as the introduction to a series of protective
inoculations. For all these reasons the second alternative was
used in the former County Borough. Surrey, however, advocated
♦the first schedule. Abrupt change of advice to parents should
obviously be avoided. It was left to the judgment of medical
officers to explain and alter arrangements as opportunity
allowed so that the second schedule was gradually applied to the
London Borough area.
No special campaigns were possible in view of the need to
consolidate administrative arrangements. Against a fortunate
background of absence of cases of disease, acceptance rates
showed the usual tendency to fall. Action for joint campaigns
with other London Boroughs was under discussion for application
in 1966.
For Tables see Appendix page 134.
HOME NURSING
This continued as a direct responsibility of the Corporation.
Suitable training arrangements were made and students accepted
for courses leading to qualification as district nurses through
the Queen's Institute for District Nursing.
For details of work carried out see Appendix page 114.