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Although immunisation is carried out in Friern
Barnet by the Middlesex County Council, this might be an
opportune moment to refer in greater detail to our
immunisation programme. During 1956, our policy was
altered only in minor respects. Thus, we decided to
use the latest available type of diphtheria antigen
(formal toxoid), this antigen having proved both efficient
and safe. We also carried out most of our immunisation
by the combined method, i.e. pertussis(whooping cough)
and diphtheria, thus limiting the number of visits which
mothers were required to pay to clinics for the immunisation
of their infants. We also found that general practitioners
were themselves immunising children in increasing
numbers, either against diphtheria alone, against diphtheria
and pertussis, or by the triple method, i.e. against
diphtheria, pertussis and tetanus. Incidentally, the
County Council scheme of immunisation does not permit of
the triple method being used. This was the position
at the end of 1956, although even by that time we were
beginning to become aware of certain difficulties.
What has transpired since belongs, rightly to a
future report. It may, however, be stated briefly
that an investigation carried out by the Medical Research
Council has shown conclusively that immunisation by the
combined method loaves the children so immunised at greater
risk of contracting poliomyelitis than would otherwise
be the case. The risk is admittedly not very great,
but the fact remains that immunisation by any combined
method which contains the pertussis antigen produces this
risk. By the time this report is written, we will
have changed to the single type of inoculation, i.e.
against diphtheria alone and against pertussis alone.
General practitioners in Friern Barnet have been informed
of the County Council's action, although, of course, the
ultimate decision will remain with the practitioner so
far as their own patients are concerned. This will
obviously mean more numerous visits to our clinics or to
the family doctor's surgery, where the practitioner has
adopted the amended procedure. All this entails added
inconvenience so far as mothers are concerned. We will
await the results of our altered programme with interest,
if not with some apprehension. Fortunately, it is hoped
that the Ministry of Health will shortly issue a statement
which will clarify the situation and may eventually
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