Immunization in childhood: submitted for the Lewis Cameron Undergraduate Prize in Bacteriology

Abstract

We wish to immunize the child in order to protect him against certain diseases to which he may be particularly prone or to induce a harmless immunity to prevent him from succumbing to other diseases when he is older. Immunization in Childhood is essentially a weapon of preventive medicine for the benefit of the whole community. It is a vast subject with a complex theoretical and experimental basis, fascinating history and promising future - and we shall be considering the subject in the light of these aspects in the following pages.

While we have chosen to study this subject from the standpoint of patterns of disease in "civilized" countries many of the procedures we have outlined are in use in less civilized areas. Smallpox springs immediately to mind but diptheria, tetanus and pertussis antigens are employed in places. B.C.G. is coming into use and may be given at an earlier age than it is here because the epidemiological situation means that infection occurs earlier; since the child population of tropical countries has a high level of subclinical immunity against polio, mass immunization is largely a luxury. In general, other preventive procedures such as yellow fever, typhoid and paratyphoid immunization take precedence over both those we have considered as regards time, personnel and economy. The problem of infectious diseases in these countries is numerically greater than and qualitatively different from the situation here; general improvements in sanitation, hygiene and living conditions and measures such as malaria control with D.D.T. make the role of Immunization in Childhood a relatively less vital one.

Finally, though its importance in medicine is established and undisputed it is a subject which is in all stages of development - depending on the aspect taken and the disease 62. studied. There is, as yet, much to conquer and explore; but it is pertinent to add the warning that unless what has been proved effective is used to the hilt. vigorously and conscientiously by medical men and women and, unless, either by legislation or, better, by publicity and education, we can achieve an effective degree of immunization in childhood, the fruits of our further endeavour cannot hope to thrive.