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The neglect of vaccination in London in recent years, to which I referred in my last report
appears to be already manifesting itself in an increase in the proportion which deaths of children from
smallpox bear to deaths from this disease at all ages. In the following table is shown in quinquennia
for the whole period, dating back from 1892, for which the information is available, the proportion of
children born, which in respect of vaccination is included under the heading "not finally accounted for,
including vaccination postponed." For the purposes of comparison is also shown the number of deaths
from this disease of children under five years of age, per cent. of deaths at " all ages."
Period.0
Children not finally accounted
for (including cases
postponed) per cent. of
total births.
Deaths from smallpox* of
children under five years of age,
per cent. of deaths from
smallpox* at all ages.
1873-77 8.1 26.1
1878-82 6.8 22.6
1883-87 7.4 25.1
1888-92 14.1 28.6
It appears therefore that with increase of neglect of vaccination of infants the deaths or children
from smallpox are contributing a larger share to the total deaths from this disease, showing the need
for the better protection of children against smallpox.
Measles.
The deaths from measles in the administrative county of London in 1895 numbered 2,630 as
compared with 3,303 in 1894.

The death rate in each year since 1840, in relation to the mean of the period 1841.95,
is shown in diagram V.
If the London death rate be compared with that of other large towns in England having more
than 200,000 inhabitants it is seen that in the ten years 1885.94 and in 1895 the London death rate
was greater than that of any of these towns, except Manchester, Liverpool, West Ham and Salford.
* Including deaths from chicken.pox. † See footnote (2), page 10.