London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Heston and Isleworth 1934
[Report of the Medical Officer of Health for Heston and Isleworth]
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1203 cases have been investigated and the results of re-testing at the end of three or four months were as follows:—
| Age | Negative after 3 Injections | Negative only after further Injections | Total Cases | Percentage not Immunised |
|---|---|---|---|---|
| 1 | 105 | 0 | 105 | 0.0 |
| 2 | 121 | 5 | 126 | 3.9 |
| 3 | 106 | 6 | 112 | 5.3 |
| 4 | 106 | 2 | 108 | 1.8 |
| 5 | 232 | 13 | 245 | 5.3 |
| 6 | 149 | 16 | 165 | 9.7 |
| 7 | 107 | 12 | 119 | 10.1 |
| 8 | 66 | 1 | 67 | 1.5 |
| 9 | 55 | 2 | 57 | 3.5 |
| 10 | 45 | 3 | 48 | 6.2 |
| 11 | 29 | 1 | 30 | 3.3 |
| 12 | 11 | 0 | 11 | 0.0 |
| 13 | 10 | 0 | 10 | 0.0 |
| Total all ages | 1142 | 61 | 1203 | 5.0 |
It will be observed that failure to immunise by this procedure amounted only to 5%, a
marked improvement on the results of the former routine, which produced 11.8% of cases
requiring further injections.
This 5% of children of course received further injections and were all ultimately shown
to have become Schick-negative.
At this point it may be profitable to discuss further the question of the extra injections
required by obstinate cases. Initially, when three injections of 1 c.cm. were employed, the failures
were treated by means of a further complete course of 3 injections of 1 c.cm.
When it became obvious that the response to the new method of immunisation was considerably
better than that obtained by the old method, a modification in the manner of treating
failures was adopted. Subjects showing a positive Re-Schick Test received 1 c.cm. immediately,
followed by a second injection of 1.5 c.cm. of T.A.M. 14 days later. This method has been found
to be satisfactory in nearly every case, and has been adopted as a routine. Only a relatively small
number of cases are found which fail to respond to this modified second series, and who require
further injections.
It must, however, be admitted that occasional cases are met with which require 9 or even
more injections before the Schick-negative state can be established. One wonders what would
be the fate of these subjects were they treated by the 'one-shot' method, uncontrolled by any
Schick or Moloney test !
The next point of outstanding importance appeared to be to determine the durability of the
immunity produced as a result of 3 injections of 1 c.cm. of T.A.M. It has not yet been possible
to investigate this point in the case of the newer method in which the larger third dose was employed,
for the work is too recent for 3 year tests to be performed.
The table appended shows the extent of reversion to some degree of Schick-positive
reaction in a group of children tested at an average of 3.6 years after they had proved to be
Schick-negative as a result of three injections of 1 c.cm. of T.A.M.
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