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6
VACCINATION.
Sex Distribution.—The total of 1,888 deaths comprised 927 deaths of males and 961 of females,
the averages for the three years 1919.21 being males 865 and females 928. The mortality rates last
year were 15.22 per 1,000 males and 11.37 per 1,000 females.
Taking the two periods of 1910.12 and 1920.22, in each of which a census was taken in the central
year, the mean mortality rates (per 1,000 of each sex) are : Males, 14.89 and 14.46 (a reduction in
the second period of 2.9 per cent.); and females, 11.34 and 10.85 (a reduction of 4.4 per cent.).
Age Distribution.—The deaths recorded during the year have been tabulated in 8 age.groups in
Table VI., from which Table mortality rates have been calculated for 6 groups for each sex, viz.:
Males, aged 0.5 years, 32.9 per 1,000; 5.15, 2.3; 15.25, 2.7; 25.45, 6.3; 45.65, 20.8; 65 and
over, 91.7. Females (same groups), 28.5, 1.2, 2.7, 3.3, 11.7, 74.4.
On this occasion the only comparison which has been made is that of the rates for the two periods
1910-12 and 1920.22 for six sex age.groups. The actual rates are not included here, but the comparison
shows that in the age group 0.5 years, the rates in the second period were 16 and 12* per cent. lower;
in the group 5-15, 12 and 13; in the group 15.25, 39 and 7 per cent. higher; in the group 25.45,
7 and 11 . lower ; in the group 45.65, 12 and 21 lower; and in the group 65 and over, 3 and
0.5 higher. The most striking fact brought out by the comparison is the great increase in the mortality
of males at the ages between 15 and 25 years. Combining the two groups 15.25 and 25.45 the mortality
for the whole was 10.92 per 1,000 in 1910.12, and 14.50 in 1920.22, an increase of 33 per cent.
Among females of the same ages (15.45 years) the mortalities were 9.99 and 9.36, a decrease in the
second period of 6 per cent. There can be little doubt about the great increase in the mortality rates
recorded among males aged 15-45 during 1920-22 being a result of the war.
Ward Distribution.—In four of the Wards the numbers recorded last year were less than the
averages, the reductions varying from 10 per cent. (Queen's Park) to 3 (Maida Vale). In the others
the increases ranged from 1 per cent. (Church) to 5 (Hyde Park). The mortality rates, calculated
on the populations given in the table, varied from a maximum of 15.6 per 1,000 (Church) to a minimum
of 9.7 (Lancaster Gate, West).
Comparing the mortality rates for the three years 1910.12 with those for the years 1920.22, lower
rates are observed in three Wards, viz., Queen's Park (reduction 7 per cent.), Harrow Road (13) and
Church (13), the increases in the other Wards ranging from 3 per cent. (Maida Vale) to 31 (Lancaster
Gate, West). The rates for males (all ages) for the same periods show changes varying from an increase
of 37 per cent. (Lancaster Gate, East) to a reduction of 18 per cent. (Harrow Road), while among
those of females a maximum increase of 36 . is observed in Lancaster Gate, West, and a maximum
reduction of 28 . in Church.
No information being at present available as to the age composition of the populations of the
Wards, no comparison of the sex.age mortalities can be given, although from comparisons which have
been made of the average numbers of deaths in the sex.age groups, changes in the mortality rates are
suggested, which are worthy of being fully investigated. The increase in the mortality rates among
males between the ages of 15 and 45 years, to which attention has already been directed, is indicated
in most of the Wards, but not all.
Causes of Death.—Table VI. contains information of the sex.age distribution of the deaths
recorded last year according to selected causes. Consideration of the changes in mortality from individual
diseases is reserved for that part of the Report headed Special Diseases.
V. VACCINATION.
The neglect of vaccination continued during 1921—the last year for which complete returns
are available—the proportion of infants not vaccinated, in accordance with the Act, being 30.2 per
cent., after excluding those that died within the first year of life without being vaccinated. In 1919
the proportion was slightly higher, viz., 30.6 per cent., but in 1920 it was 28.3.
During the last four years smallpox has shown signs of increasing prevalence in the Country.
In 1919, 262 cases were notified in England and Wales, 24 of the cases occurring in London. In 1920
the corresponding numbers were 243 and 18, in 1921, 311 and 2, and in 1922, 985 and 62. Last year's
cases, outside the Metropolis, were reported principally in the Northern and Midland Counties, viz.,
Yorkshire, North Riding (253), West Riding (232), Durham (240), Lancashire (63) and Nottinghamshire
(94). In the other counties affected the cases were few, Kent being the only one with a total reaching
10. Of the 985 cases, 176 were reported in the first quarter of the year, 304 in the second, 211 in the
third and 294 in the fourth.
The first cases reported last year in the Metropolis occurred in the third quarter, when 7 cases
were notified. At the beginning of November the outlook in London was sufficiently disturbing
to call for special action.
* In each instance the rate for males is stated first.