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Intradermal immunization. Diphtheria
207
ABSTRACTS
three injections of scarlatinal streptococcus toxin. Half received 800, 1,600, and 3,200 skin test doses, respectively, and half received 1,600, 3,200, and 8,000 skin test doses. In all a reversal of the Dick test was obtained when tests were made three months later. Fifty per cent of the children receiving the larger dose had some constitutional complaint following at least one injection. This consisted of fever, vomiting, headache, or rash in order of frequency. Urinalyses were negative. Of the children receiving the smaller dose of toxin, 21 per cent had a constitutional reaction after at least one injection, and again urinalyses were negative. There was no relationship between severity of reaction and age which is contrary to most reports. The intradermal method of immunization against scarlet fever is felt to be superior to the subcutaneous’method because three rather than jive injections are given and reactions are fewer and milder. An interesting observation in the course of the study was that in the instances when it was closely followed almost half of the children ‘developed a positive reaction to the control test after immunization indicating a hypersensitivity to the protein of the toxin. This tended to reach its height three months after the last dose and then to disappear gradually. Intradermal D. W.:
Immunization. Am. J. Dis. Child.
Diphtheria. Blatt, 62: 757, 1941.
M. L.,
Fischer,
S., and
van
Gelder,
Of 945 children between 1 day and 19 years of age who were given Schick tests, They were immunized intradermally with either alum228 reacted positively. precipitated toxoid or plain toxoid, both of which seemed gatisfactory as immunizing agents, according to the authors. Due possibly ,to the small number in each group, however, there was considerable variability of response. For example, in thirty-eight children given two doses of 0.1 C.C. and 0.2 c.c., respectively, of alum toxoid, there were none with positive Schick tests at the end of eleven months. Of twenty children who were given a larger total dose (two doses of 0.2 C.C. each), three had a positive Schick test nine months later. Systemic reactions were minimal even in the older age group, and it is this fact which recommends the intradermal method. Unmodified toxoid produced less severe local reactions than alum-precipitated toxoid, which may cause considerable immediate pain on injection, lasting several hours. Alum toxoid occasionally caused sterile abscesses as well. The preferred method of diphtheria immunization is stated to be the intradermal injection of two doses of 0.1 C.C. and 0.2 c.c., respectively, of unmodified toxoid at an interval of three weeks, followed by a third if the Schick reaction is still positive.
Inlxadermal Am.
J. Dis.
Immunization. Child.
62:
Typhoid 933,
Fever.
Van
Gelder,
D.
W.,
and
Fischer,
S.:
1941.
Five hundred and eighty children in the Illinois Soldiers’ and Sailors’ School between 1.5 and 19 years of age were immunized against typhoid fever. Fifty per cent were immunized intradermally, using a total dose of 0.25 C.C. to 0.45 c.c., and others were immunized subcutaneously with a total dose of 2.5 C.C. Local and general reactions were very much fewer in the intradermally immunized group. Their H, or flagellar, agglutinin titer was as high as that of the subcutaneously immunized group, but their 0, or somatic, agglutinin titer was much less. Whether an interval of two or three weeks was used did not affect the subsequent agglutinin response. A total dose of 0.30 C.C. was recommended when the intradermal method was used in subjects weighing 120 pounds or more.
ABSTRACTS
three injections of scarlatinal streptococcus toxin. Half received 800, 1,600, and 3,200 skin test doses, respectively, and half received 1,600, 3,200, and 8,000 skin test doses. In all a reversal of the Dick test was obtained when tests were made three months later. Fifty per cent of the children receiving the larger dose had some constitutional complaint following at least one injection. This consisted of fever, vomiting, headache, or rash in order of frequency. Urinalyses were negative. Of the children receiving the smaller dose of toxin, 21 per cent had a constitutional reaction after at least one injection, and again urinalyses were negative. There was no relationship between severity of reaction and age which is contrary to most reports. The intradermal method of immunization against scarlet fever is felt to be superior to the subcutaneous’method because three rather than jive injections are given and reactions are fewer and milder. An interesting observation in the course of the study was that in the instances when it was closely followed almost half of the children ‘developed a positive reaction to the control test after immunization indicating a hypersensitivity to the protein of the toxin. This tended to reach its height three months after the last dose and then to disappear gradually. Intradermal D. W.:
Immunization. Am. J. Dis. Child.
Diphtheria. Blatt, 62: 757, 1941.
M. L.,
Fischer,
S., and
van
Gelder,
Of 945 children between 1 day and 19 years of age who were given Schick tests, They were immunized intradermally with either alum228 reacted positively. precipitated toxoid or plain toxoid, both of which seemed gatisfactory as immunizing agents, according to the authors. Due possibly ,to the small number in each group, however, there was considerable variability of response. For example, in thirty-eight children given two doses of 0.1 C.C. and 0.2 c.c., respectively, of alum toxoid, there were none with positive Schick tests at the end of eleven months. Of twenty children who were given a larger total dose (two doses of 0.2 C.C. each), three had a positive Schick test nine months later. Systemic reactions were minimal even in the older age group, and it is this fact which recommends the intradermal method. Unmodified toxoid produced less severe local reactions than alum-precipitated toxoid, which may cause considerable immediate pain on injection, lasting several hours. Alum toxoid occasionally caused sterile abscesses as well. The preferred method of diphtheria immunization is stated to be the intradermal injection of two doses of 0.1 C.C. and 0.2 c.c., respectively, of unmodified toxoid at an interval of three weeks, followed by a third if the Schick reaction is still positive.
Inlxadermal Am.
J. Dis.
Immunization. Child.
62:
Typhoid 933,
Fever.
Van
Gelder,
D.
W.,
and
Fischer,
S.:
1941.
Five hundred and eighty children in the Illinois Soldiers’ and Sailors’ School between 1.5 and 19 years of age were immunized against typhoid fever. Fifty per cent were immunized intradermally, using a total dose of 0.25 C.C. to 0.45 c.c., and others were immunized subcutaneously with a total dose of 2.5 C.C. Local and general reactions were very much fewer in the intradermally immunized group. Their H, or flagellar, agglutinin titer was as high as that of the subcutaneously immunized group, but their 0, or somatic, agglutinin titer was much less. Whether an interval of two or three weeks was used did not affect the subsequent agglutinin response. A total dose of 0.30 C.C. was recommended when the intradermal method was used in subjects weighing 120 pounds or more.