PhD Thesis - ResearchSpace@Auckland - The University of Auckland

Using the family doctor in this way had been the Department’s aim from the advent of
diphtheria immunisation in the 1920s as it did not have the resources to routinely
immunise all children and believed that doctors were better situated to achieve this
aim. This policy has since remained in place. However, many campaigns which had
been so successful in schools did not achieve the same results for preschoolers when
the immunisations were to be given by the family doctor. There were a variety of
reasons for this which included cost (up to 1972), access to the family doctor and
transport. The lower levels of immunisation compliance for preschoolers in
comparison to those children in school was of grave concern to the Department and
was the subject of immunisation initiatives to boost levels throughout the period.
The way immunisation was promoted and the amount of information available to
parents also changed over time. Originally consisting of a few lines on a consent
form in the 1920s, by the 1990s colourful pamphlets which explained the vaccine and
some of its side-effects were commonplace. The main reason behind this was the
growing acceptance of the idea of informed consent, where parents were given
enough knowledge and information to be able to make an educated decision regarding
whether or not to immunise their child. Most of these changes occurred in the 1980s.
However there were other influences already in place, such the establishment of
Health Education Officers by the Health Department in the 1950s. Their brief was to
promote health which included the benefits of immunisation and they appeared to
have made some impression.
There were changes over time in the way Maori and other ethnic minorities were
perceived by the Department and how immunisation was promoted to them. In the
1920s, typhoid immunisation was portrayed as virtually mandatory by the Health
Department and parental consent requirements were not adhered to, the Health
Department believing the gaining of such consents was too difficult. This began to
alter with the widespread promotion of diphtheria immunisation in the 1940s and
1950s when consent for immunisation had to be obtained from every parent, including
Maori. From the 1970s more attention began to be paid to the special requirements of
Maori health and later Pacific Island health, by the Health Department. This was
demonstrated by initiatives such as Plunket’s government contract in South Auckland
to raise the standards of child health and immunisation. Nevertheless, as with Pakeha,
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