PhD Thesis - ResearchSpace@Auckland - The University of Auckland

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Child Immunisation: Reactions and Responses to New Zealand Government Policy 1920-1990. by Alison Suzanne Day A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in History. The University of Auckland, 2008.
ABSTRACT My thesis has explored the history of child immunisation in New Zealand from a socio-medical perspective. The framework has been hinged around the actions and immunisation strategies of the Health Department over the period 1920 to 1990 and the responses of parents to those actions and strategies. One of the most important concepts considered was how the Health Department decided on and then implemented immunisation policy during the period. Health professionals played a significant role in the delivery of immunisation to children and have impacted on a number of policy changes. After World War Two, with an increase in the number of vaccines on offer, the specialised expertise of the World Health Organization and the Epidemiology Advisory Committee in policy determination became very influential. The responses to departmental immunisation policies by parents demonstrated a significant change during the period, although most apparent in the 1980s. From a situation of wariness (and perhaps indifference) in the 1920s and 1930s to almost total vaccine acceptance from the 1950s, the 1980s were, by contrast, illustrative of parental assertiveness especially concerning side-effects. The advent of feminism in the 1970s and the issues of informed consent in the mid-1980s assisted in raising levels of parental awareness in immunisation which continued into the 1990s. Ethnic and socio-economic background also contributed to different levels of acceptance of immunisation, which will be addressed. Opposition to immunisation tended to wax and wane during this period. Two groups were dominant, although at opposite ends of the time spectrum. Both were small but vocal in their views. Nevertheless, neither group made much impression on New Zealand parents, although they were both an irritant to the Health Department. Overseas experiences in immunisation were interwoven throughout my thesis to set the New Zealand events in an international context. The introduction of a particular vaccine was compared and contrasted with similar schemes elsewhere to give an ii
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Page 5 and 6: ACKNOWLEDGEMENTS I would most espec
Page 7 and 8: LIST OF ABBREVIATIONS AJHR Appendic
Page 9 and 10: CHAPTER 1: Introduction ‘It doesn
Page 11 and 12: immunisation’s ‘Golden Age’ b
Page 13 and 14: of polio in Canada up until 1962. 1
Page 15 and 16: There was however, little attempt t
Page 17 and 18: mandatory smallpox vaccination had
Page 19 and 20: the effect of changes and different
Page 21 and 22: Using the family doctor in this way
Page 23 and 24: complicated nature of this task for
Page 25 and 26: Before I could commence interviewin
Page 27 and 28: journals, both locally and overseas
Page 29 and 30: developments were also taking place
Page 31 and 32: Zealand’s first true ‘mass’ i
Page 33 and 34: In the United States there was a si
Page 35 and 36: CHAPTER 2: Curtailing the ‘Assass
Page 37 and 38: more immediate concern to parents w
Page 39 and 40: the district offices in Napier, Wha
Page 41 and 42: advised that antiseptic should be u
Page 43 and 44: an intensive two and half year camp
Page 45 and 46: programme in schools that had been
Page 47 and 48: Wellington instigated a programme t
Page 49 and 50: Low rates of diphtheria also meant
Page 51 and 52: of artificial immunity to diphtheri
Page 53 and 54:
parents regarding the lack of infor
Page 55 and 56:
immunisation was to be presented
Page 57 and 58:
Maori and Typhoid Immunisation In 1
Page 59 and 60:
vaccine. 127 In one case a Maori pu
Page 61 and 62:
Department before finally erupting
Page 63 and 64:
after World War Two, although durin
Page 65 and 66:
CHAPTER 3: ‘Get Them Young’. Th
Page 67 and 68:
from 47,698 cases in 1939 to 35,994
Page 69 and 70:
priority it for the Health Departme
Page 71 and 72:
undertake the immunisation work. 32
Page 73 and 74:
and his generally unhelpful attitud
Page 75 and 76:
were admitted to hospital suffering
Page 77 and 78:
previously. Manufacturers were requ
Page 79 and 80:
convulsions or encephalopathy were
Page 81 and 82:
cases of encephalitis or similar we
Page 83 and 84:
old boy contracted tetanus when a r
Page 85 and 86:
In New Zealand Glaxo Laboratories o
Page 87 and 88:
published in the New Zealand Medica
Page 89 and 90:
campaign’. 130 Up until September
Page 91 and 92:
y the 1940s, it was still felt by t
Page 93 and 94:
Quebec government began BCG vaccina
Page 95 and 96:
campaign. The Health Department’s
Page 97 and 98:
tested with 2391 discovered to be p
Page 99 and 100:
Tuberculosis Division, undertook a
Page 101 and 102:
This scepticism focused not on the
Page 103 and 104:
CHAPTER 4: ‘Something Everybody D
Page 105 and 106:
opportunities denied and discrimina
Page 107 and 108:
In 1949, the Department of Maori Af
Page 109 and 110:
The proposal was approved by Cabine
Page 111 and 112:
found to be giving poor protection
Page 113 and 114:
the ‘Radio Doctor’, he gave adv
Page 115 and 116:
16, found that 88 per cent were Sch
Page 117 and 118:
accepted that mothers were still re
Page 119 and 120:
answered in a reassuring manner. 79
Page 121 and 122:
having the combined vaccine which c
Page 123 and 124:
District had two clinics in its cen
Page 125 and 126:
subject from the National Anti-Vacc
Page 127 and 128:
misleading’ and found it was typi
Page 129 and 130:
wish to immunise on these grounds.
Page 131 and 132:
views on society as a whole, not ju
Page 133 and 134:
CHAPTER 5: From Salk to Sabin: inte
Page 135 and 136:
although as Anne Hardy noted, it di
Page 137 and 138:
ecame known, resulted in 204 cases
Page 139 and 140:
safety standards were higher than A
Page 141 and 142:
with a growing number of vaccines o
Page 143 and 144:
examine the Salk vaccine. Commencin
Page 145 and 146:
immune to all three types of poliov
Page 147 and 148:
concerned that the vaccine was safe
Page 149 and 150:
not supply enough vaccine. The Comm
Page 151 and 152:
to have it bussed in an icebox from
Page 153 and 154:
officer who had often been engaged
Page 155 and 156:
parents. 112 This incident demonstr
Page 157 and 158:
information. 125 Some parents found
Page 159 and 160:
daughter contracted polio and becam
Page 161 and 162:
expected to be infants and preschoo
Page 163 and 164:
A. W. S. Thompson, the Auckland Med
Page 165 and 166:
‘handle the problems of storage a
Page 167 and 168:
Publicity Publicity for the campaig
Page 169 and 170:
October 1962, which was seen as suc
Page 171 and 172:
together in one place, the preschoo
Page 173 and 174:
The concerns about vaccine safety r
Page 175 and 176:
CHAPTER 6: Re-inventing Disease Per
Page 177 and 178:
social conditions’ as part of a r
Page 179 and 180:
vaccine, as was demonstrated by hig
Page 181 and 182:
However, others believed there had
Page 183 and 184:
measles vaccine in 1970 drew the wr
Page 185 and 186:
those who believed that measles was
Page 187 and 188:
Rubella Vaccine Another significant
Page 189 and 190:
with a limited population, it shoul
Page 191 and 192:
percent of the expected total with
Page 193 and 194:
einforcing or booster dose of vacci
Page 195 and 196:
and trouble involved, whether any e
Page 197 and 198:
This recommendation was not untimel
Page 199 and 200:
from both Britain and the United St
Page 201 and 202:
different approach had to be employ
Page 203 and 204:
Hamilton District it was found that
Page 205 and 206:
Medical opinions tended to vary ove
Page 207 and 208:
ead and butter line’ and immunisa
Page 209 and 210:
Refugees. 2 This strong influence w
Page 211 and 212:
debates in medical circles surround
Page 213 and 214:
51.2 percent of those aged one to f
Page 215 and 216:
demonstrated that no departmental c
Page 217 and 218:
magazine published four times a yea
Page 219 and 220:
stations broadcast information rela
Page 221 and 222:
protected from brain injury and the
Page 223 and 224:
98.1 percent. 76 Although the Depar
Page 225 and 226:
months previously at 12 months old.
Page 227 and 228:
measles, as demonstrated by the epi
Page 229 and 230:
1282 BCGs were given to ‘at risk
Page 231 and 232:
American and British medical litera
Page 233 and 234:
egime for children which used a fif
Page 235 and 236:
Representations for funding were ma
Page 237 and 238:
During 1987 the reservations of the
Page 239 and 240:
long for the campaign to prevent di
Page 241 and 242:
initiatives, than it did to the con
Page 243 and 244:
SV40 and that its administration wa
Page 245 and 246:
it was generally believed both in N
Page 247 and 248:
demonstrated that some parts of the
Page 249 and 250:
against polio, up from 59 percent i
Page 251 and 252:
Aberdeen University, who made a stu
Page 253 and 254:
assurances of safety by the JCVI in
Page 255 and 256:
Polio Vaccine and SV40 1983 The Off
Page 257 and 258:
inquiring about the link’. 76 Man
Page 259 and 260:
Department had acted properly with
Page 261 and 262:
1974 not to talk to the press about
Page 263 and 264:
this view and it was at this point
Page 265 and 266:
matter. 117 Nevertheless, two newsp
Page 267 and 268:
parental confidence in the vaccine;
Page 269 and 270:
only company producing a vaccine su
Page 271 and 272:
Vaccine Does U-Turn’ was the head
Page 273 and 274:
parents now willing to do this, in
Page 275 and 276:
The growth of parental awareness re
Page 277 and 278:
triple vaccine (diphtheria, tetanus
Page 279 and 280:
ecoming Our Bodies, Ourselves. 11 T
Page 281 and 282:
ut also because ‘I could not see
Page 283 and 284:
commented that she attended Green B
Page 285 and 286:
encourage discussion by parents, al
Page 287 and 288:
The Immunisation Awareness Society
Page 289 and 290:
which persuaded her to seek out mor
Page 291 and 292:
Nevertheless the IAS can only be re
Page 293 and 294:
knew they had to have their kids va
Page 295 and 296:
to their attention, and the establi
Page 297 and 298:
August 1988. Cartwright’s report
Page 299 and 300:
To identify attitudes to immunisati
Page 301 and 302:
antibodies to the disease. 131 Meas
Page 303 and 304:
of immunisation issues was not show
Page 305 and 306:
CHAPTER 10: Conclusion Childhood im
Page 307 and 308:
e a significant portion of the popu
Page 309 and 310:
of booster or top-up programmes. Th
Page 311 and 312:
Zealand began to forge some of its
Page 313 and 314:
There is still much scope for more
Page 315 and 316:
1968 AGE PROGRAMME 3 months Triple
Page 317 and 318:
At birth 6 weeks 3 months 5 months
Page 319 and 320:
Primary Sources - Unpublished Archi
Page 321 and 322:
144/17 25622 Polio Vaccine Committe
Page 323 and 324:
Auckland Museum Library Homebirth A
Page 325 and 326:
Personal Interviews Russell Kerse -
Page 327 and 328:
Health of the Special Committee to
Page 329 and 330:
Ashworth, N. (1988). ‘Hepatitis B
Page 331 and 332:
Campbell-Begg, R. (1982). ‘Immuni
Page 333 and 334:
Davidson, W. C. ‘The Mantoux Tube
Page 335 and 336:
Findlay, K., Parker, C., Westaway,
Page 337 and 338:
Auckland University Press. Hickling
Page 339 and 340:
Lindner, U., Blume, S. S. (2006).
Page 341 and 342:
three reduced doses’. New Zealand
Page 343 and 344:
187-88. Porter, M. (1987). ‘Vacci
Page 345 and 346:
troubled path to acceptance in Brit
Page 347 and 348:
Wehrle, P. F., Top, F. H. Snr, eds.
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