London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Kensington 1903
The annual report on the health, sanitary condition, etc., etc., of the Royal Borough of Kensington for the year 1903
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The actual figures, showing loss, both for the Metropolis and the rest of England, during the twenty years 1881-1900, as set out in the report of the Local Government Board lor 1902-3, are as follows:—
| Metropolis. Cases lost. | Rest of England. Cases lost. | Metropolis Cases lost. | Rest of England. Cases lost. | ||
|---|---|---|---|---|---|
| 1881 | 5.7 per cent. | 4.3 per cent. | 1891 | 16.4 per cent. | 12.9 per cent. |
| 1882 | 6.6 „ | 4.5 „ | 1892 | 18.4 „ | 14.3 „ |
| 1883 | 6.5 „ | 4.9 „ | 1893 | 18.2 „ | 15.7 „ |
| 1884 | 6.8 „ | 5.3 „ | 1894 | 20.6 „ | 19.0 „ |
| 1885 | 7.0 „ | 5.5 „ | 1895 | 24.9 „ | 19.8 „ |
| 1886 | 7.8 „ | 6.1 „ | 1896 | 26.4 „ | 22.3 |
| 1887 | 9.0 „ | 6.7 „ | 1897 | 29.1 „ | 21.6 „ |
| 1888 | 10.3 „ | 8.2 „ | 1898 | 33.0 „ | 19.6 „ |
| 1889 | 11.6 „ | 9.6 „ | 1899 | 27.7 „ | 15.4 „ |
| 1890 | 13.9 „ | 10.9 „ | 1900 | 25.8 „ | 13.9 „ |
These figures show both the great increase in annual "loss," from 1881 onward to 1898, and
that the new Act which came into operation in 1899 has brought about a considerable increase in
the number of primary vaccinations. The cost to the country has been great, but the Act clearly
has justified the policy of the Local Government Board, at whose instance it was introduced. The
Board, in their annual report for 1901-2, referring to the vaccination returns for 1899, observed that
"the increased acceptance of primary vaccination"—at a time precedent to the epidemic of small-pox
—is to be "referred to the altered conditions under which, consequent upon the Vaccination Act,
1898, and their regulations made thereunder, vaccination is now performed, and the increased
facilities which now exist for its performance." One of the most potent influences tending to the
increase in the number of vaccinations in normal years, is the provision for the use of glycerinated
calf lymph, which has cut the ground from under the feet of those who objected to vaccination because
of the possibility of enthetic disease being conveyed in humanized lymph.
Vaccination Authority.—The question as to the future vaccination authority was brought to
public attention again in the early part of 1903 by a deputation of the Imperial Vaccination League
to the President of the Local Government Board. The deputation and the President were agreed
as to the desirability of transferring the administration of vaccination law from the Boards of Guardians
to some other authority. The President, however, did not commit himself as to what that other
authority should be, and, with other questions, this one stands in abeyance, pending a suitable
opportunity for fresh legislation.
Calf Lymph.—The statutory duty of the Local Government Board in respect to the supply of
lymph only requires them to provide for the needs of public vaccinators for primary vaccinations,
but the Board actually provide the lymph required for re-vaccinations also. And this is a necessity,
for arm-to-arm vaccination, i.e., the use of humanized lymph, is discouraged, and indeed is now
impracticable owing to the abolition of public vaccination stations since the passing of the
Vaccination Act, 1898. The President of the Board informed the deputation referred to in the
preceding paragraph that it would be impossible to supply lymph generally to medical men all over
the country. But having regard to the enormous production of the lymph during the small-pox
epidemic of 1901-2, one cannot but think that such a supply as was indicated by the President—
50,000 charges a week—equal to 2,600,000 charges a year, would suffice for all requirements. In
1902, public vaccinators made 82,214 applications for calf lymph, and 962,000 charged capillary
tubes were sent out. These officers were accountable for just under 50 per cent. of the vaccinations
performed in that year at the public expense, and I think it reasonable to assume that the needs of
private practitioners would have been amply met by the balance of more than one million and a
half of tubes.
Re-vaccination.—The most urgent need of the time, as regards protective measures against
small-pox, is a provision for promoting re-vaccination of children at twelve or thirteen years of age
—a time of life at which the protection afforded by infant vaccination is beginning to be, or has
been, largely impaired. This question was also dealt with by the deputation to the President of the
Local Government Board from the Imperial Vaccination League, last year. The plan has long
been practised in Germany with the result that small-pox amongst the natives of that empire is
almost unknown. The President made no revelation of the intentions of the Government, nor,
indeed, of his own views, which he thought it more prudent to suppress till the time for action
should have come. During the current Session a Bill to give effect to the proposal, introduced
into the House of Commons at the instance of the League, has received extensive municipal,
scholastic, and medical support.