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Am J Dis Child. 1921;21(5):472-476. doi:10.1001/archpedi.1921.01910350059007.
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My object in reporting these cases is to have on record the fact that diphtheria can occur among children who possess either natural immunity or who have been immunized by the toxin-antitoxin procedure. If we are to utilize our knowledge of diphtheria immunity intelligently, without prejudice to the community or to the child who has suspicious sore throat, and raise the bars of precautions against a disease of so many possibilities, we must be sure that our interpretative value of a negative Schick reaction will stand the test of time and experience, and particularly that immunity, as obtained by the toxin-antitoxin instillation, is sufficiently universal in its application that not even an occasional exception will alter its value. An immunity recorded by a negative Schick reaction should not be sufficient, and only when a sufficient number of Schick negative immunized children have been exposed to diphtheria contagion and have escaped


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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