demand. Two incidents in particular are highlighted: an epidemic in Coventry in 1957; and the death of the professional footballer Jeff Hall in 1959. The chapter ends with the introduction of oral poliomyelitis vaccine and the end to these long-running supply issues.
As well as covering demand, the rhetoric around polio vaccine exposes other themes that we have already encountered in the 1950s and 1960s vaccination programmes. The general climate of demand was welcome, but the government was consistently worried about pockets of apathy shown by
globe – as did the emergence of the WHO. 7 Thus, while routine vaccination continued until 1971 and ports were monitored for signs of importation, Britain's national protection was to come from international cooperation and a battle fought well away from its own shores.
Smallpox was a deadly infectious disease which came in two forms. Variola major had a death rate of around 20 per cent, while the weaker variola minor had a death rate of around 1 per cent. All could lead to excessive scarring and complications in survivors. 8 While public health
In 1940, diphtheria became the first vaccine of the bacteriological age to be offered free to British children on a national scale. It achieved impressive results in its first years, reducing the case load from over 46,000 in 1940 to just 962 in 1950, and deaths from 2,480 to 49. 1 Medical authorities celebrated this success, but were mindful of the paradox they had created. With diphtheria no longer a common disease, would parents stop immunising their children? And if they did, would a disease that should be eliminated make a deadly
diphtheria-tetanus (DT) and whole-cell pertussis vaccines were available. 19 The whooping cough vaccine was successful. Pertussis morbidity dropped significantly over the 1960s, from an average of 122,000 cases (and 374 deaths) per year in the ten years ending 1956, to just 20,400 cases (and 24 deaths) per year for the ten years ending 1970 ( Figure 4.1 ). 20
Figure 4.1 Pertussis notifications, England and Wales, 1940–2005. After 2005, improvements in laboratory testing and notifications mean
might reduce the burden on other health services, it noted that there were 90,000 measles cases in 1986 and over 1,000 hospital admissions. Parents who did not present their children for measles vaccination were placed implicitly in the same category as people making poor dietary choices (‘obesity: a quarter of young people are overweight’), smokers (‘100,000 deaths a year … 50 million working days lost … £400 million in [NHS] treatment costs’) and drug users (‘the number of addicts newly notified in 1986 exceeded 5,000’). 10 But while this responsibility rhetoric
public had contradictory expectations with regard to disease management. On the one hand, parents had ceased to be overly concerned about diseases that were now so rare that few had direct experience of severe complications or death. To some extent this was evident in the diphtheria programme in the 1950s, but was considered especially prominent with pertussis in the 1970s and measles in the 1990s. On the other hand, reports of the increased morbidity of vaccine-preventable diseases reflected poorly on the government and the nation as a whole. These contradictions
England and Wales, 1900–1974’; Gorsky, ‘Public health in interwar Britain’.
72 Lewis, ‘The Prevention of diphtheria’. See, for example, the government files detailing correspondence between such groups as the Anti-Vaccination League and the British Union for the Abolition of Vivisection in: The National Archives (hereafter TNA): MH 55/293; MH 55/1720; HO 45/10768/273078; and passim.
73 See Hooker, ‘Diphtheria, immunisation and the Bundaberg tragedy’; Peter Hobbins, ‘ “Immunisation is as popular as a death adder”: The