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Immunizing Children: A Practical Guide,
  1. P T RUDD, Consultant paediatrician

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    Immunizing Children: A Practical Guide, 2nd ed. By Mayon-White R, Moreton J. (Pp 104, paperback; £14.95.) Oxford: Radcliffe Medical Press, 1998. ISBN 8 577 5219 8 .

    Although immunisation is one of the most effective forms of medical intervention, the increasing scepticism with which it is viewed by a significant number of parents means that those involved in the process need to be fully informed.

    The authors of Immunizing childrenacknowledge the stimulus provided by parents, their questions, and their reluctance to accept immunisation. This book appears to provide a bridge between the “Green book” Immunisation against infectious disease (London: HMSO, 1996) and the consumer.

    The early part discusses vaccine development (trial phases), and explains the immunological background, before going on to describe the characteristics of the preventable infections. There is a section on immunisation schedules, considerations and contraindications, immunisation procedures, and care of vaccines. The last part of the book considers reactions and parents’ questions.

    This book is in many respects less comprehensive than the “Green book”. The descriptions of the infectious diseases are irritatingly simplistic and at times show ignorance of current practice: thus epiglottitis resulting from Haemophilus influenzae type B infection is described as “ . . .inflammation of the throat which blocks the entrance to the windpipe. Children . . .died by suffocation unless they were immediately treated by antibiotics and in some case by a tracheostomy.” Tracheostomy has not been used as treatment for many years. Similarly rubella and diphtheria are said to cause heart damage and this rather simple approach has led to important omissions—no mention of the serious consequences of measles in the immunosuppressed child. Egg allergy is a common problem in children yet it is covered in a short, rather uninformative paragraph.

    The section on common worries will be useful to health professionals who have to reassure parents about measles–mumps–rubella, Crohn’s disease, and autism. Some background references in this section would have been useful.

    This book is a useful addition to the literature on immunisation. I suspect its greatest benefit will be to the professional who needs information for the sceptical parent.

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