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

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London County Council 1900

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

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17
Since the year 1880 the Registrar-General has classified the deaths from small-pox under
three heads, viz., "vaccinated," "unvaccinated," and "no statement." The totals for the
twenty years 1881-1900 are as follows—

Small-pox deaths, London,1881-1900.

Age-period.All ages.0-11-55-2020-4040-6060-8080 and upwards.
vaccinated1,2862233229732228393
Unvaccinated2,032337486669416105181
No statement1,909244227455667250633

The following table, in which the number of deaths at each age-period is expressed as a
percentage of the total deaths from small-pox at "all ages," more clearly indicates the relative
age incidence of the disease in the three classes under consideration—

" All ages" taken as100.

Age-period.All ages.0-11-55-2020-4040-6060-8080 and upwards.
Vaccinated1001.72.617.857.017.73.00.2
Unvaccinated10016.623.933.020.45.20.90.0
No statement10012.811.923.834.913.13.30.2
" Vaccinated " and " no statement " combined.
"Vaccinated" and "No statement"1008.38121.443.815.03.20.2
Unvaccinated10016.623.933.020.45.20.9o.o
" All ages" taken as 100.
Age-period.All ages.0-11-55-2020-4040-6060-8080 and upwards.
Vaccinated1001.72.617.857.017.73.00.2
Unvaccinated10016.623.933.020.45.20.90.0
No statement10012.811.923.834.913.13.30.2
" Vaccinated " and " no statement " combined.
"Vaccinated" and "No statement"1008.38121.443.815.03.20.2
Unvaccinated10016.623.933.020.45.20.9o.o

In previous reports I have referred to the increasing proportion of children born in London
who appear in the vaccination returns as "not finally accounted for." The proportion in successive
years has been as follows. The figures for the years subsequent to 1898 are not yet
available.

London vaccination returns.

Year.Children not finally accounted for (including cases postponed) per cent. of total births.Year.Children not finally accounted for (including cases postponed) percent. of total births.
18728.818867.8
18738.718879.0
18748.8188810.3
18759.3188911.6
18766.5189013.9
18777.1189116.4
18787.1189218.4
18797.8189318.2
18807.0189420.6
18815.7189524.9
18826.6189626.4
18836.5189729.1
18846.8189833.0
18857.0
London vaccination returns.
Year.Children not finally accounted for (including cases postponed) per cent. of total births.Year.Children not finally accounted for (including cases postponed) percent. of total births.
18728.818867.8
18738.718879.0
18748.8188810.3
18759.3188911.6
18766.5189013.9
18777.1189116.4
18787.1189218.4
18797.8189318.2
18807.0189420.6
18815.7189524.9
18826.6189626.4
18836.5189729.1
18846.8189833.0
18857.0

In diagram VI. is shown the changing age incidence of mortality from small-pox in London
in successive periods since 1841. In the period 1842-50 deaths of children under 5 years of age
constituted nearly 70 per cent. of the total deaths. In successive decennia this proportion
decreased until it reached a minimum in the decennium 1881-90, when it constituted about 25 per
cent. of the total deaths. In the last decennium, 1891-1900, it has somewhat increased. The
difference between the behaviour of small-pox and that of measles and whooping-cough in this
respect is also shown by the diagram. The reduction in successive periods is no doubt due to
the increase of infantile vaccination, and the increase in the last decennium is very suggestive
when the neglect of infantile vaccination in recent years is borne in mind. The diagram also
enables comparison to be made between the age distribution of small-pox deaths registered in
1881-1900 among the "vaccinated" and "unvaccinated." The age distribution of the large
"vaccinated" population is probably very much that of the population as a whole, and if this
view be correct the small mortality under five years of age is significant. "With respect to the
smaller " unvaccinated " population the age distribution is more doubtful, and it cannot be stated
to what extent a larger proportion of children under five years of age in this class of the population
has contributed to the results shown. Estimate may, however, be made of the proportion of
children under ten years of age in the London population who in 1898 were unvaccinated,
assuming that the general rate of mortality has been the same among vaccinated and unvaccinated
children, and that those who in the vaccination returns are described as "unaccounted for" were