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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.
ii 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
appreciable understanding of New Zealand’s position. Vaccine controversies overseas were also examined to determine their influence in New Zealand.
Immunisation policy has been shaped by a myriad of factors and influences from both inside and outside the country. There were extensive changes over the years in the way parents, health professionals and the Health Department perceived immunisation which will be examined in my thesis.
iv
ACKNOWLEDGEMENTS
I would most especially like to thank my main supervisor, Associate Professor Linda Bryder for her guidance, help and support during the years it has taken me to
complete this thesis. Without her encouragement and calm acceptance of the major changes that have occurred in my life whilst writing it I doubt I would have been able to finish. I owe her a heartfelt debt of gratitude that I have finally made it!
To my second supervisor, Mrs Judith Bassett, my sincere thanks for all your insightful and pertinent comments and most particularly for your help in finding people for me to interview during my research. I have been very privileged to have two excellent supervisors, who both complemented each other.
There are other people whom I wish to thank. To my parents-in-law Ruth and Norman Parker who kindly proof-read the thesis for me and offered grammatical assistance I am indebted to you both. To Kate Prebble who really helped me in the last stages, I am most grateful. To all the people in the History Department who gave up their valuable time to be interviewed by me and who also put me into contact with other people you are much appreciated. I would also like to express my gratitude to the History Department for awarding me the Myra and Eric McCormick Scholarship in History which proved invaluable during the first few years.
Finally, a special thank you to my husband Michael Parker who supported me financially after my scholarship finished and has offered many words of encouragement and advice right until the very end.
TABLE OF CONTENTS
Abstract ii
Acknowledgements iv
Table of Contents v
List of Abbreviations vi
Chapter 1: Introduction 1
Chapter 2: Curtailing the ‘Assassin of Children’. Diphtheria
immunisation in New Zealand 1920-1941 27 Chapter 3: ‘Get Them Young’. The Health Department and the
expansion of childhood immunisation 1941-1962 57 Chapter 4: ‘Something Everybody Did?’ Attitudes and responses
to immunisation policy 1941-1962 95
Chapter 5: From Salk to Sabin: international influences on polio
vaccine policy in New Zealand 1955-1962 125 Chapter 6: Re-inventing Disease Perception: immunisation and
public health policy 1962-1972 167
Chapter 7: ‘Slow to Change?’ The Health Department and
immunisation policies 1972-1990 200
Chapter 8: ‘Crises of Confidence?’ Vaccine controversies and
medical and public responses 1973-1990 234 Chapter 9: Empowerment and Expectation: the changing nature of
parental attitudes towards immunisation 1973-1990 268
Chapter 10: Conclusion 297
Appendix 1: Immunisation Schedules 1964-1990 306
Appendix 2: Table of Immunisations 1920-1990 310
Bibliography 311
vi
LIST OF ABBREVIATIONS
AJHR Appendices to the Journals of the House of Representatives
ANZ Archives New Zealand
APVDC Association of Parents of Vaccine-Damaged Children
AS Auckland Star
BCG Tuberculosis Vaccine BMJ British Medical Journal
BUAV British Union for the Abolition of Vivisection CARE Citizens Association for Racial Equality
CDCAC Communicable Disease Control Advisory Committee
CIS Carcinoma in Situ
CS Christchurch Sun
CSL Commonwealth Serum Laboratories
D Dominion
DHSS Department of Social Security (Britain) DGH Director General of Health
DNZB Dictionary of New Zealand Biography DPH Department of Public Health
DT, double Combined Diphtheria and Tetanus vaccine
DTP, triple Combined Diphtheria, Tetanus and Pertussis vaccine EAC Epidemiology Advisory Committee
EP Evening Post
FDA Federal Drug Administration
GP General Practitioner
HART Halt All Racist Tours HBCT Hepatitis B Control Team
IAS Immunisation Awareness Society IMAC Immunisation Advisory Centre IPV (Salk) Inactivated Polio Vaccine
JCVI Joint Committee of Vaccination and Immunisation MJA Medical Journal of Australia
MOH Medical Officer of Health
MMR Mumps, Measles and Rubella vaccine
MRC Medical Research Council (Britain)
MWWL Maori Women’s Welfare League
NCES National Childhood Encephalopathy Study NZAVS New Zealand Anti-Vivisection Society NCSS New Zealand Crippled Children Society
NZG New Zealand Gazette
NZH, Herald New Zealand Herald
NZMA New Zealand Medical Association NZ Listener New Zealand Listener
NZMJ New Zealand Medical Journal NZNJ New Zealand Nursing Journal NZPD New Zealand Parliamentary Debates NZT, Truth New Zealand Truth
NZYB New Zealand Yearbook
ODT Otago Daily Times
OPV (Sabin) Oral Polio Vaccine
PHN Public Health Nurse
PMD Public Health Dissertation SMO School Medical Officer
SST Sunday Star Times
SSPE Subacute Sclerosing Panencephalitis
TAB Typhoid Vaccine
WHO World Health Organization
WT Waikato Times
