{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:25:38Z","timestamp":1785536738312,"version":"3.56.0"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2011,1,13]],"date-time":"2011-01-13T00:00:00Z","timestamp":1294876800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>In January 1940 British Ministry of Health circular 1307 proposed the introduction of mass childhood diphtheria immunization. This was a policy reversal after a decade during which opportunities for diphtheria prophylaxis were ignored, or resisted on grounds of cost. Diphtheria toxoid was to be the first of many centrally funded childhood immunizations in the UK and it set a pattern that has now held good for over 70 years. The circumstances in 1940 were particularly fortuitous, and diphtheria toxoid has since given successive generations of children a lifetime's protection from the disease; but difficulties have been experienced in introducing and evaluating some of the more recent immunizations, and in maintaining and justifying them in the face of parental scepticism and academic or pressure-group opposition, however ill-founded this may have been. The task of decision-making with regard to new candidate vaccines demands a careful balancing against the costs of the expected benefits during the recipient's lifespan.<\/jats:p>","DOI":"10.1017\/s095026881000302x","type":"journal-article","created":{"date-parts":[[2011,1,13]],"date-time":"2011-01-13T14:01:13Z","timestamp":1294927273000},"page":"487-493","source":"Crossref","is-referenced-by-count":9,"title":["The diphtheria vaccine debacle of 1940 that ushered in comprehensive childhood immunization in the United Kingdom"],"prefix":"10.1017","volume":"139","author":[{"given":"P. P.","family":"MORTIMER","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2011,1,13]]},"reference":[{"key":"S095026881000302X_ref033","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.02.034"},{"key":"S095026881000302X_ref016","first-page":"178","article-title":"Diphtheria toxoid in the prevention of diphtheria in Canada","volume":"23","author":"Fitzgerald","year":"1930","journal-title":"Canadian Medical Association Journal"},{"key":"S095026881000302X_ref029","volume-title":"Immunisation against Infectious Disease","author":"Salisbury","year":"2006"},{"key":"S095026881000302X_ref009","first-page":"6","article-title":"On diphtheria toxin and anatoxin, their power as floccules and their immunizing properties [in French]","volume":"38","author":"Ramon","year":"1924","journal-title":"Annales de l'Institut Pasteur"},{"key":"S095026881000302X_ref025","unstructured":"25. Sheldon S , Active immunisation against diphtheria. Medical Research Council Special Report Series no. 195, 1934."},{"key":"S095026881000302X_ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/MMBR.7.1.1-41.1943","article-title":"The types mitis, intermedius and gravis of Corynebacterium diphtheriae","volume":"7","author":"McCleod","year":"1943","journal-title":"Bacteriological Reviews"},{"key":"S095026881000302X_ref017","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.22.1.25"},{"key":"S095026881000302X_ref026","first-page":"273","article-title":"Diphtheria not prevented","volume":"i","year":"1940","journal-title":"Lancet"},{"key":"S095026881000302X_ref013","volume-title":"The Schick Inoculation for Immunisation against Diphtheria: An Exposure of its Dangers and Fallacies","author":"Bayly","year":"1939"},{"key":"S095026881000302X_ref023","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.22.3.237-b"},{"key":"S095026881000302X_ref012","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.4235.315"},{"key":"S095026881000302X_ref006","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.13.1.23"},{"key":"S095026881000302X_ref003","first-page":"31","volume-title":"War on Disease: a History of the Lister Institute","author":"Chick","year":"1971"},{"key":"S095026881000302X_ref030","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(03)00302-5"},{"key":"S095026881000302X_ref018","first-page":"41","volume-title":"Control of Common Fevers","author":"Fitzgerald","year":"1942"},{"key":"S095026881000302X_ref021","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2.4.250"},{"key":"S095026881000302X_ref007","volume-title":"The Control of Communicable Diseases","author":"Paul","year":"1952"},{"key":"S095026881000302X_ref002","first-page":"123","volume-title":"History of Immunisation","author":"Parish","year":"1965"},{"key":"S095026881000302X_ref014","first-page":"209","volume-title":"Vaccinia and Encephalitis in Recent Advances in Bacteriology","author":"Dible","year":"1932"},{"key":"S095026881000302X_ref028","first-page":"1249","article-title":"A balance of risks [injection paralysis]","volume":"ii","year":"1956","journal-title":"Lancet"},{"key":"S095026881000302X_ref024","first-page":"556","article-title":"GPs and diphtheria prophylaxis","volume":"i","year":"1942","journal-title":"British Medical Journal"},{"key":"S095026881000302X_ref004","volume-title":"Diphtheria Past and Present","author":"Forbes","year":"1932"},{"key":"S095026881000302X_ref015","first-page":"11","article-title":"Connaught and the defeat of diphtheria","volume":"9","author":"Rutty","year":"1996","journal-title":"Contact"},{"key":"S095026881000302X_ref022","first-page":"640","article-title":"Immunisation against diphtheria (review of \u2018La vaccination contre la diphterie\u2019)","volume":"ii","author":"Debre","year":"1932","journal-title":"British Medical Journal"},{"key":"S095026881000302X_ref011","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1929.02700490001001"},{"key":"S095026881000302X_ref032","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c655"},{"key":"S095026881000302X_ref008","volume-title":"Hazards of Immunisation","author":"Wilson","year":"1956"},{"key":"S095026881000302X_ref001","first-page":"439","volume-title":"The Greatest Benefit to Mankind","author":"Porter","year":"1997"},{"key":"S095026881000302X_ref005","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1922.02640190022009"},{"key":"S095026881000302X_ref019","first-page":"27","volume-title":"Control of Common Fevers","author":"Harries","year":"1942"},{"key":"S095026881000302X_ref031","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)01239-8"},{"key":"S095026881000302X_ref010","first-page":"291","article-title":"Application of diphtheria anatoxin to active immunization of man and prophylaxis against diphtheria [in French]","volume":"45","author":"Ramon","year":"1930","journal-title":"Annales de l'Institut Pasteur"},{"key":"S095026881000302X_ref027","unstructured":"27. Hartley PA .Study of diphtheria in two areas of Great Britain. Medical Research Council Special Report Series no. 272, 1951."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S095026881000302X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T15:16:52Z","timestamp":1592234212000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S095026881000302X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,1,13]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2011,4]]}},"alternative-id":["S095026881000302X"],"URL":"https:\/\/doi.org\/10.1017\/s095026881000302x","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,1,13]]}}}