In Britain all children are routinely offered immunisation against polio, diphtheria, tetanus, pertussis, measles, and from now on, mumps and rubella. The uptake in many regions, however, is far below the target of 90%1 especially for measles and pertussis, and morbidity and mortality remain unacceptably high. 2 One major reason is misunderstanding over contraindications by doctors and health visitors3 leading to children being mistakenly denied protection. 4 The 1988 edition5 of the DHSS Memorandum ‘Immunisation Against Infectious Disease’ has clarified many issues, changed previous contraindications,6 and extended protection to some children previously left vulnerable to pertussis. It should be, available for reference in all immunisation clinics. This article is a guide to the highlights of the Memorandum; the relevant paragraphs are given in brackets in the text.
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