Does vaccination prevent smallpox? : a lesson taught from the Gloucester epidemic / by C.R. Drysdale.

  • Charles Robert Drysdale
Date:
1896
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Licence: Public Domain Mark

Credit: Does vaccination prevent smallpox? : a lesson taught from the Gloucester epidemic / by C.R. Drysdale. Source: Wellcome Collection.

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    THIS year is the centenary of the experiment on vaccination made by Dr. Edward Jenner, of Berkeley, Gloucestershire. On the nth May, 1796, Dr. Jenner vaccinated a boy eight years old from a sore on the hand of a dairymaid, who was infected by her master’s cows. On July 1st, 1796, the boy was inoculated with smallpox matter, taken from a pustule ; but no disease followed. Several months after this the boy was again inoculated with smallpox matter, but no sensible effect was produced on his constitution. Here then was the commencement of humanized vaccination, a practice which has continued till our times, and has been, until recently, accepted as the best preservative against the ravages of smallpox. The early vaccinators could test all their vaccinations by subsequent smallpox inoculation, and thus the pre¬ vention by vaccination was clear to all experienced practitioners in the early years of this century. The question before us this evening is whether vaccination prevents smallpox, and what can we learn from the account of the epidemic in Gloucester. Let us, then, see what the facts were. In an account of that epidemic, on March 21st, it was stated that the number of cases of smallpox had risen from 50 to 70, and then to 170 in one week. It was also stated that Gloucester was one of the towns in which the anti-vaccination agitation seemed to have produced the greatest success, and that, as in Leicester, a large proportion of children and young persons had remained unvaccinated. The law of compulsory vaccination had been allowed to fall into abeyance, since the authorities seemed to await the Report of the Royal Commission before enforcing it. When 495 cases had been chronicled, the deaths stood at 93, with only 100 complete recoveries. In the first ten weeks of the present * year there were twenty-six deaths of children under ten years of age, all of whom were among the unvaccinated, whilst no vaccinated child had died. Twenty years ago, the vaccination law was so well carried out in Gloucester that only about five per cent, of children escaped vaccination ; but latterly as many as 80 per 100 children born were left unvaccinated. All modern physicians of experience know that vaccination in infancy only protects as a rule for a certain number of years, and that it is necessary to revaccinate at least once on arriving at maturity, and the fact that deaths occurred in the Gloucester and other epidemics among adults who had been vaccinated in infancy only points to the necessity of our imitating the Prussian medical authorities and revaccinating all children at the age of twelve years, a practice which, as I shall show, has extirpated smallpox from Germany. Dr. Bond, Officer of Health of Gloucester, issued a statement (British Medical Journal, April nth, 1896) oi the result of the cases in the smallpox hospital of that city. From this it appears that up to March 27th, 365 persons had been admitted since June 1895 into the smallpox hospital, of whom 207 were unvaccinated ; 158, chiefly adults, vaccinated ; and only one re-vaccinated. There had been 81 deaths, and 70 of these deaths occurred among the unvaccinated, and 11 deaths among those who had been only vaccinated in infancy (chiefly adults); 33*8 per cent., or more than one- third of the vaccinated died of the disease, and seven per cent of those (chiefly adults) vaccinated only in infancy. Of the 70 unvaccinated deaths all but three were of children under ten years of age, two of the three were of the ages ot eleven and fourteen, and the third unvaccinated death was of the age of 21. None of the deaths occurred in any vaccinated patient under the age of 27 years. It would appear from these facts that vaccination gives a degree of protection against death from smallpox for the earliest years of life which is for all practical purposes nearly certain, even when it does not altogether protect adults against an attack of the disease. The great majority, too, of the unvaccinated children who recovered had the disease very severely and will be badly disfigured through life. The ages of the vaccinated persons attacked at Gloucester were :—Under 10, 2 ; under 20,42 ; 22502807237