London's Pulse: Medical Officer of Health reports 1848-1972

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West Ham 1950

[Report of the Medical Officer of Health for West Ham]

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continued to be by means of regular sessions at each of the Council's Maternity and Child
Welfare Clinics, together with periodical visits to the schools to immunise those children
missed in the pre-school age, and to give refresher doses to those who had been previously
immunised. General Practitioners are also authorised to carry out this work on behalf of
the Council.
The decision of the Council to offer combined immunisation against diphtheria and
whooping cough was implemented in March. This entailed certain changes in procedure. Only
two injections separated by an interval of one month had been required for immunisation
against diphtheria alone, the new vaccine required the administration of three doses at monthly
intervals. Since almost all parents have accepted combined immunisation this has considerably
increased the work of the doctors and clerical staff concerned. A further change was consequent
upon the fact that the vast majority of fatal dases of whooping cough occur in the
first two years of life and especially in the first twelve months. In order to ensure the
maximum protection during this vulnerable period, children are now offered combined immunisation
at three months of age instead of at eight months as was the case when diphtheria prophylactic
alone was given.
It was recognised, when the decision was taken to vary the normal age for immunisation,
that this was a departure from accepted practice. Careful enquiries were, therefore, made
and expert advice was obtained from the Medical Research Council to ensure that reasonable
scientific basis existed to justify the change. The main risk to be feared was that at such
an early age the all important diphtheria immunisation might not be fully effective. It
appeared, however, that, with the methods proposed, there was a good prospect that it would
prove successful though it would probably require the administration of "refresher" dose at
a rather earlier age than is usual, and it was, therefore, decided to proceed on a trial basis.
As a check on the efficacy of the method it is proposed to offer Schick tests to the first
thousand or so of the babies who are immunised in this way about the time they reach their
first birthday. These methods will then be reviewed in the light of the findings.
In July with the occurrence of cases of poliomyelitis it was decided to suspend all
immunisation, since available evidence suggested that injections given to children during
the incubation period of this disease might be a factor in precipitating the onset of paralysis.
It was not until November that it was felt to be safe to restart this work. Every effort is now
being made to overtake the arrears which have accumulated in consequence of this suspension,
especially in respect of young children.

The following figures show the number of children immunised during the year:-

AgeCompleted Full CourseRefresher Doses (Diph.only)
Diphtheria onlyCombined Whooping Cough and Diphtheria
Under 5 years509937-
5-14 years43185