VACCINATION.

Press, Volume LXV, Issue 19735, 27 September 1929, Page 8

VACCINATION.

INSTRUCTIONS TO DOCTORS ONE INSERTION, NOT FOUR. (FROM orp. OiVS COBKESPONDEXT.) LONDON, August 23. Important changes in the rules governing vaccination are made in an order which has been issued by the Minister for Health, MrW. Greenwood, and which comes into force on October Ist. Reference is made in a circular accompany ing the order to the mysterious new disease known as post-vaccinal encephalitis (brain inflammation), a number of deaths from which has alarmed the public this year. The circular recalls the remarks of the Ministry of Health committee of experts in its report last year that such cases are of serious import and- cannot fail to have an effect on vaccination. The committee also pointed to the extreme rarity of such manifestations, particularly after revaccination and after primary vaccination in early infancy, and concluded that early infancy remains the time of choice for ! primary vaccination. Tn view of the fact that post-vaccinal | diserise lias occurred mainly in children of school age and adolescents, the Minister recommends that: long as the smallpox prevalent in this country retains its present, mild character, it is not generally-expedient to press for the vaccination of persons of these ages who have not previously been vaccinated. Based on the report of a committee appointed by the Ministry in conjunction with the Medical Research Council, the order lays it down that in future there shall be: Only one insertion in ordinary cases; _ The inspection of all children vaccinated ; Free additional treatment when necessary for children vaccinated by public vaccinator; and Kcvaccination at any time, instead of only after ten years. "The aim of the vaccinator." it is "should be to produce the most successful results with the minimum of injury." Nervous Disease. Attention is drawn to the occurrence of •'post-vaccinal nervous disease." "The Committee point out," it is stated, "that, however seldom such cases may they are of serious import and cannot fail to have an effect on vaccination both in its administrative and in its purely medical aspects. Bnt the Committee also point to the extreme rarity of such manifestations, particularly after revaccination and after primary vaccination in early infancy, and they conclude that early infancv remains the time of choice for primary vaccination. "The Minister recognises tbat_ 'postvaccinal nervous disease,' both in this country and: abroad, has occurred mainly in children of school age or adolescents who had never previously been vaccinated, and that this fact emphasises the desirability of securing the successful vaccination of infants. Where this has not been Attained, the question which arises is whether it is advisable to vaccinate children of school age or adolescents. The Minister is of opinion that, in the present state of knowledge, and so long as the sma.Hnox prevalent in this country ret a i ns i ts n resent mild, character, it is not generally expedient to press for the vaccination of persons of these ages who have not previously been vaccinated unless they have been in personal contact with a case of smallpox or directly exposed to small pox infection."' 'Unknown Character." Several fatal cases of encephalitis', fnllnwiiic vaccination, have been the subject of comment by Coroners and medical authorities within recent

weeks. In one such oase, in July, Dr. R. L. Guthrie, the East London Coroner, paid: "It is to be supposed that some uiiknov7t> factor exists—perhaps bacterial, or a filter-passing virus, or » latent virus which, by means of a reciprocal reaction, determines the occurrence of these accidents. Between three and 13 is the time that this disease is particularly liable to occur." The new order makes no reference to the uw of more dilute lymph.