Armstrong – Table of Contents

of the most careful investigation. The Public Health Service is anxious to learn of such
cases should they occur and would be glad to render any assistance possible in the study
of them”.
In response to this request Armstrong was able to report (20) after several years
on 72 cases occurring in the United States. This information, published in the Public
Health Reports, was based on the “Cutter Lecture” delivered in Boston, Massachusetts
March 31. 1932. Armstrong also suggested changing the terminology of this entity from
“postvaccinal” to “postvaccination encephalitis” since vaccine was isolated in only rare
instances from the central nervous system, and the complication usually occurred
temporally with the height of the vaccination reaction. Armstrong also offered a possible
explanation for the etiology and pathogenesis of the encephalitis based on
epidemiological and experimental observations. He also offered and suggested a
therapeutic strategy designed hopefully to prevent the occurrence of this tragic event that
resulted in 37 to 42 per cent mortality.
The etiology of postvaccination encephalitis is still indeterminate (21). During the
period of discontinuation of routine vaccinations in the United States after 1972
opportunities for additional studies on this problem have been minimal to non-existent.
According to Armstrong (21), “In the absence of definite information as to the etiology of
postvaccination encephalitis, attempts at its prevention are more or less empirical.
However, it is an established fact that primary infant vaccinations and likewise secondary
vaccinations performed at any age tend to be relatively quite unlikely to be followed by
this complication. Now, in both of these relatively insusceptible groups, the vaccination
reactions tend to be milder than is the rule among primary reactions performed after the