PhD Thesis - ResearchSpace@Auckland - The University of Auckland

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My thesis considers the implications of the New Zealand Health Department’s immunisation policies, on parents and health professionals, from a social viewpoint. Determined by a range of sources and taking account of international influences, a comprehensive picture of childhood immunisation in New Zealand from 1920 will be attempted. My work aims to fill a gap in New Zealand historiography as there has been little written about the history of immunisation except as part of the story of a disease and only for a specific time period. Similarly, it attempts to contribute to the international historiography through the examination of subject from a socio- historical perspective and is explored as a topic in its own right. My thesis places New Zealand’s immunisation experiences in an international context which many other works in this field have not attempted to do. 26
CHAPTER 2: Curtailing the ‘Assassin of Children’. Diphtheria immunisation in New Zealand 1920-1941 New Zealanders, both Maori and Pakeha, were familiar with immunisation. Smallpox vaccination had been compulsory in the Dominion since 1863 although by the early part of the twentieth century compliance was negligible due to the perceived low risk of infection and the inherent unpleasantness of the vaccination. 1 Diphtheria immunisation was introduced into a society with mixed views regarding the necessity of such injections and their benefits. In this chapter the cautious path adopted by the New Zealand Health Department in its use of this vaccine and the events which shaped policy, such as the 1928 Bundaberg tragedy, will be discussed. Developments in New Zealand will also be examined within an international setting, with comparisons made to diphtheria immunisation schemes set up in Canada and in New York City during the same period. Opposition to immunisation was a feature of these two decades; although not widespread, it was vehement in its condemnation, and its impact on public acceptance will be assessed. There was some Maori opposition to the typhoid immunisation scheme that the Health Department began to establish during the 1920s which will be analysed in conjunction with issues of consent for Maori which were to have serious implications for the Department in the 1940s and 1950s. 1920 Public Health Act and consent Vaccination was incorporated within health legislation in the 1900 Public Health Act instead of under a separate statute as had been the case previously. This move now established it as the responsibility of the newly-formed Department of Health. The 1 There is a difference between vaccination and immunisation. Vaccination was a term originally used in connection with smallpox when lymph or vaccine was introduced into the body in order to render the individual immune from the disease. Immunisation is defined as a process or procedure that protects the body against infectious disease by stimulating the production of antibodies. It is more common now to use the term immunisation which has become all-encompassing to include vaccination. The term immunisation will be used during this thesis except for BCG and smallpox which are both referred to as vaccinations. In keeping with this terminology, anti-immunisers will be used to describe those opposed to immunisation. 27
Page 1 and 2: http://researchspace.auckland.ac.nz
Page 3 and 4: ABSTRACT My thesis has explored the
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: In the United States there was a si
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
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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
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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
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‘handle the problems of storage a
Page 167 and 168:
Publicity Publicity for the campaig
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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
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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
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with a limited population, it shoul
Page 191 and 192:
percent of the expected total with
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einforcing or booster dose of vacci
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and trouble involved, whether any e
Page 197 and 198:
This recommendation was not untimel
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from both Britain and the United St
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different approach had to be employ
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Hamilton District it was found that
Page 205 and 206:
Medical opinions tended to vary ove
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ead and butter line’ and immunisa
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Refugees. 2 This strong influence w
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debates in medical circles surround
Page 213 and 214:
51.2 percent of those aged one to f
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demonstrated that no departmental c
Page 217 and 218:
magazine published four times a yea
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stations broadcast information rela
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protected from brain injury and the
Page 223 and 224:
98.1 percent. 76 Although the Depar
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months previously at 12 months old.
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measles, as demonstrated by the epi
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1282 BCGs were given to ‘at risk
Page 231 and 232:
American and British medical litera
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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
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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
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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
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matter. 117 Nevertheless, two newsp
Page 267 and 268:
parental confidence in the vaccine;
Page 269 and 270:
only company producing a vaccine su
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Vaccine Does U-Turn’ was the head
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parents now willing to do this, in
Page 275 and 276:
The growth of parental awareness re
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triple vaccine (diphtheria, tetanus
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ecoming Our Bodies, Ourselves. 11 T
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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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PhD Thesis - ResearchSpace@Auckland - The University of Auckland

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