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children in the schools and school clinics. A grand total of 6,858 were
treated in this year, this including 1,184 at infant welfare centres and 1,094
at schools or school clinics. At the end of the year it was estimated some
31.5 per cent. of children under 15 had been immunised, and 25.6 per cent.
of those under five. In 1942 7,366 altogether were treated, including
1,977 at infant welfare centres and 713 at schools. At the end of the
year, of children under five, 42.5 per cent. were immunised and of children
of school age 52.1 per cent. At one time authorities were advised that
doses of A.P.T. as small as 0.1 c.c. and 0.3 c.c. were as effective as the
previously recommended doses of 0.2 and 0.5 c.c. ; with larger supplies
coming through the bigger doses were accepted as standard. The results
of the Schick tests though were the same whatever had been the dosage.
Early in 1943 the income limit which precluded those above it being
treated under the Council's arrangements was removed. From the same
time A.P.T. was issued free of charge to medical practitioners. In the
year, 5,427 children were treated, 1,532 at the centres and 2,220 at
schools. At the end of the year 69 per cent. of children of school age and
46.1 per cent. of those under five were protected.
There was a marked falling off in the number of children immunised
in 1944 only 2,359 being treated, 1,327 of them at the welfare centres,
149 at the local war nurseries and only 28 at the local schools. At the
end of the year, 45.3 per cent. of those under five were thought to be
protected, 54.7 per cent. of those of school age.
There was a slight improvement in 1945 when 3,111 were treated,
of whom 1,934 were done at the infant welfare centres, 44 at the nurseries,
and 110 at the schools. At the end of the year, 53.4 per cent., of children
under 5 years of age and 53.7 per cent. of school children were protected.
Local efforts in the way of posters, letters to medical practitioners, and
the special efforts of medical officers and health visitors supporting the
national campaign of publicity, were possibly responsible for the improvement.
As mentioned in the report for 1944, though, it is felt that efforts
should be concentrated on maintaining a high standard of immunity in
the under-fives. In circular 194, the Ministry recommended that attention
be devoted to children of 9 to 12 months of age. Fortunately, these
are groups which can be most easily reached by those operating the
maternity and child welfare services, and the offering of these facilities
at the infant welfare centres should do much to ensure that a high proportion
of children of these ages are treated. Theoretically, if a high
proportion of the population have been treated the standard should be
maintained if the number of children treated in any one year is not less
than the number of births in the district. While under the influence of
special conditions such as an outbreak of diphtheria or special propaganda
these numbers might be exceeded, it is felt though, this is a desirable
target which is capable of attainment. The Ministry decided (circular
194, dated 14.11.45) that in future the responsibility for immunising
children under five years of age is to be placed on welfare authorities.
Hitherto, as it was a measure to control the spread of infectious disease,
it had been the responsibility of the sanitary authorities.
Diphtheria in the Inoculated : Vaccination against smallpox fell
into disrepute partly, perhaps, because more had been claimed for it than