The administration of scarlet fever streptococcal toxin in effective dosage for active immunization is often followed by undesirable local and general reactions when the injections are made by the usual subcutaneous route.

Evidence has been accumulating that the skin may be utilized advantageously as a route of absorption for various vaccines and toxins in producing active immunity. In 1931 Tuft (1) compared the antibody-response following 4 weekly injections of mixed typhoid vaccine by the subcutaneous, intramuscular and intracutaneous routes in human beings. Subsequent serologic study of these individuals showed that the degree of antibody-production was equal to that found after the use of the other routes of injection. The total number of bacteria injected intracutaneously was one-seventh the number injected by the other routes. Tuft remarks upon the relatively “large number of negative or slight (one plus) local reactions after intradermal injection” and “the extremely low percentage of the constitutional symptoms occurring after the intradermal injections as compared with the others.”

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