Volume 2

Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission.

  • Great Britain. Royal Commission on Vaccination.
Date:
1889-1897
Catalogue details

Licence: Public Domain Mark

Credit: Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    662/798 (page 90)
    tion indueed by tlie existence of an epidemic of small-pox has played no small part in checking the spread of the disease and narrowing its limits. It seems to have been a very important factor in controlling the epidemic. 842. Summing up, then, the evidence on the subject of re-vaccination so far as regards this country, we find that particular classes within the community amongst whom re-vaccination has prevailed to an exceptional degree have exhibited a position of quite exceptional advantage in relation to small-pox, although these classes have in many cases been subject to exceptional -risk of contagion. We find, further, taking the evidence as a whole, that in the population at large re-vaccinated persons seem to be in a position much more advantageous not only than the unvaccinated, but than adults who have only been vaccinated in infancy. There is another conclusion suggested by the evidence to which we ought to advert, for it is of importance. Where re-vaccinated persons were attacked by or died from small-pox, the re-vaccination had for the most part been performed a considerable number of years before the attack. There were very few cases where a short period only had elapsed between the re-vaccination and the attack of small-pox. This seems to show that it is of importance in the case of any persons specially exposed to the risk of contagion that they should be re-vaccinated, and that in the case even of those who have been twice vaccinated with success, if a long interval since the last operation has elapsed, the operation should be repeated for a third, and even for a fourth time. 343. A comparison has been instituted between the annual mortality from small-pox of males and females per million living at different ages for the three decennia between ] 851-1880, and it has been suggested that an inference unfavourable to vaccination is to be drawn from this comparison, inasmuch as the mortality of males exceeds that of females, whilst the former were presumably the better vaccinated class. It is to be observed, however, that if the age below 15 be separately regarded, when infantile vaccination would be most protective, and when the conditions of exposure would probably be much the same, there is no substantial difi'erence between the mortality of males and females. Above the age of 15, when the male population would be likely to be exposed to the risk of contagion more than the female, the deaths amongst the male population were considerably more than among the female. There is no reason to believe that this increased risk was counterbalanced to any material extent owing to a much larger proportion of the male population having been re-vaccinated than of the female. There is every reason to think that only a small proportion of either class had submitted to the operation of re-vaccination. The number of those who pass through the army is not large in proportion to the total population. And, on the other hand, the number of females employed as domestic servants, whose re-vaccination would be likely to be attended to, exceeds that of men so employed. 344. In discussing the effect of vaccination upon the fatality of small-pox, and the attack-rate and type of the disease, we have referred exclusively to materials derived from experience acquired in England. We have done so, because we posess the records of a careful examination into the circumstances of epidemics which occurred in that part of the United Kingdom. We have already insisted upon the importance of the reports which embody the results of those investigations. We do not possess any information of the same character with reference to the incidents of small-pox epidemics in other parts of the United Kingdom. We have not referred to the reports we received with regard to the other epidemics because they were of a more limited scope, and the information was derived more from other persons and less from a systematic investigation by the medical man appointed by our- selves. Nevertheless they contain much information with regard to the incidence of small-pox upon the vaccinated and unvaccinated which is in conformity with the results derived from the more complete investigation of the epidemics in the other towns. The records of the small-pox hospitals in London, which we have quoted, furnish the particulars of a very large number of cases. We have no similar records relating to any thing like the same number of cases either in Scotland or Ireland. We have pointed out the superior value of statistical results, when derived from a large number of cases. Eor these reasons we do not propose to refer specifically to the evidence drawn from experience in Scotland or Ireland, bearing upon the question whether vaccination diminishes the fatality of small-pox or renders persons less liable to be attacked by, or to suffer severely from it. This much, however, we may say, that the evidence relating to those parts of the United Kingdom does not in any way tend to modify the conclusions to which a study of the evidence relating to England leads. On the contrary, its tendency is to confirm and strengthen them.