London's Pulse: Medical Officer of Health reports 1848-1972

View report page

London County Council 1892

[Report of the Medical Officer of Health for London County Council]

This page requires JavaScript

13
that all the 67 were efficiently vaccinated at that age. In 4 cases no marks of vaccination were to be
seen, and of these, 1 had the disease slightly, 2 moderately, and 1 (aged 22) severely, which proved
fatal. It is highly probable that these four cases should properly be included under the heading of
'unvaccinated' or 'unsuccessfully vaccinated.' In two others the scar was scarcely perceptible, in one
of these the disease was moderate, in the other confluent and fatal; in a number of others the vaccination,
as judged from the number and appearance of the scars, appears to have been of low quality, but
in all who presented any clear signs of having been vaccinated the disease was less severe, ran a shorter
course than ordinary smallpox, and was in no case fatal. Two cases in persons over 40 years of age are
stated to have been re-vaccinated, one of these at the age of 10 years, the other in India about 20 years
ago. both were mild cases."

The report of the Statistical Committee of the Metropolitan Asylums Board for the year 1892. supplies the following figures relating to cases of smallpox admitted during that year into the hospital ships—

Total vaccinated cases admitted218,deaths3
Cases in which there was "no evidence" as to cicatrices140„ 13
Cases in which vaccination cicatrix was "absent"62„ 17

In 1881 the Registrar General began to classify the deaths from smallpox according to whether the deceased was stated to be vaccinated, unvaccinated, or whether there was no statement as to vaccination. The totals of the twelve years 1881-92 are as follows—

All ages.0—11—55—2020—4040-6060—8080 and upwards.
Vaccinated1,1751928219674201313
Unvaccinated1,87629943263839498141
No statement1,793234219438618226562

The proportion in which the vaccinated and unvaccinated died from smallpox at the different ages will be seen by reference to the following figures, the later age of death of the vaccinated contrasting with the earlier age of death of the unvaccinated.

All ages taken as 100.0—11—55—2020—4040—6060—8080 and upwards.
Vaccinated1001.62.418.657.417.12.60.3
Unvaccinated10015.923.034.021.05.20.70.1
No statement10013.112.224.434.512.63.10.1

This difference of age-incidence, although less marked, is still observable when the numbers relating to "Vaccinated" and "No statement" are combined, as will be seen by reference to the following table—

All ages taken as 100.0—11—55—2020—4040—6060—8080 and upwards.
Vaccinated and " No statement"1008.58.322.143.514.42.90.2
Unvaccinated10015.923.034.021.05.20.70.1

The Council receives no returns relating to vaccination, but a few of the medical officers of health
publish in their annual reports a tabular statement showing the results obtained during the year. To
some others I am indebted for information specially supplied to me by them. The tabular statements
contained in the annual reports and the information thus afforded me show that during the year 1892 there
was a marked falling off in the number of infants vaccinated, and in some districts the number "unaccounted
for including vaccinations postponed" attained large proportions. In Hackney, Limehouse, and
Poplar, this number is more than 20 per cent. of the births, in Hackney more than 40 per cent. Among
those districts having from 15 to 20 per cent. are Pancras, St. Giles, St. Martin-in-the-Fields, Strand,
St. Luke, St. Olave, and Battersea; and from 10 to 15 per cent., Chelsea, Islington, Shoreditch, St.
George-in-the-East, St. Saviour, Southwark, St. George-the-Martyr, and Wandsworth.
*The report of the Committee points out that "under this heading are included cases stated to have
been vaccinated but bearing no visible evidence of the operation, and also cases in which no statement was made,
but the nature of the complaint, or other cause, prevented any observation of the marks, if any existed."