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22 Report of the Barnstable County Health Department for 1969 To the Board of Health Town of Mashpee I am pleased to submit this annual report of the Barn- stable County Health Department for the year 1969. On August 20, 1969 Rubella (German Measles) vaccine was made available by the Massachusetts Department of Public Health. Rubella is usually a mild disease. It assumes tremendous importance when a pregnant woman contracts the disease during the first trimester of pregnancy because of the possibility of congenital defects in the newborn. There is a 20 per cent risk of a dead or deformed infant. Thus, the most important objective of a Rubella Control Program is the prevention of maternal rubella. This can best be accom- plished at the present time by reducing the reservoir of f rubella virus in the community through the immunization of children. Children, particularly in the early grades of school, are the biggest source of infection to mothers who are still susceptible. They are also the major source of transmission of the disease in the community. The objective of the 1969-1970 school year is to immunize both boys and girls, kindergarten through grade three with plans to eventu- ally include children one year through junior high school age. The increased needs for all kinds of services, the con- tinued rise in costs creating competition for the tax dollar and the need to improve the use of the available profession- ally prepared human resources demands that all provider agencies must cooperate in planning for and in the delivery of the needed health services for every citizen in Barnstable County. We see the present reorganization rocess o f the Massa- chusetts Department of Public Health and the State Compre- hensive Health Planning Program for Massachusetts as two important steps in helping the local health agencies in reaching this goal. The "Barnstable" area provider and con-