PhD Thesis - ResearchSpace@Auckland - The University of Auckland

Tuberculosis Division, undertook a review of BCG policy under the direction of V. S.
Land, the Assistant Director. Notice was taken of the WHO recommendations which
advocated BCG for ‘at risk’ groups only in countries where the incidence of
tuberculosis was declining; however, adolescence was considered to be a period of
high risk. 185
In November 1962, when Land wrote to a number of chest physicians seeking their
views on adolescent BCG; nine were in favour with six against. 186 He also found that
for both European and Maori the incidence in the unvaccinated was still too high to
consider stopping BCG. Maori under-fives had an incidence rate of 19.5 per 10,000
in 1960 in comparison to 1.52 per 10,000 for European preschoolers. 187 Land
therefore recommended that were possible vaccination of Maori new-borns and
school entrants should be introduced. This followed the WHO guidelines which
advocated the vaccination of new-borns, school entrants and school leavers in areas
where the prevalence of tuberculosis was high.
The Hutt Health District, on its own initiative, had already implemented a scheme in
1958 for Public Health nurses to vaccinate Maori infants as it ‘is the Maori children
under 5 years...who would benefit most from B.C.G.’. 188 Land’s recommendations,
rather than stopping the BCG programme, advocated increasing it to reach the more
vulnerable sections of society. However, they were then considered by a committee
of senior Health Department staff including Land himself. 189 The committee decided
that no action was to be taken with regard to implementing BCG vaccination for
Maori infants and school entrants. Taking an opposite stance to Land’s report it was
also decided to discontinue BCG vaccination in the South Island and use a programme
of tuberculin testing instead to identify positive reactors. (The South Island had
already stopped its BCG programme after the 1961 Medical Officer of Health
conference). 190 The ‘relatively small Maori population’ was also a determining factor
185
ibid.
186
ibid.
187
ibid.
188
ibid., also MOH Lower Hutt to DGH, 21 September 1964, H1 34419 246/64, ANZ, Wellington.
189
The committee comprised of H. B. Turbott, C. A. Taylor, D. P. Kennedy, G. O. L. Dempster and V.
S. Land.
190
Circ. Memo 1963/26 4 February 1963, H1 246/64 34419 BCG Vaccination 1956-69, ANZ,
Wellington.
91