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Beyond the clause in the Act which makes vaccination compulsory in the case of
children born after the passing thereof, the paramount object of the various provisions
is of course to secure its general and efficient application. The question thus
naturally arises how far the Vaccination Act has been successful in this direction.
The Act has been passed upwards of three years and yet small-pox prevails to an
alarming extent. It is of little avail to point to certain model communities or
districts and insist that the operation of the Act has there been to stamp out smallpox.
Circumstances alter cases, and so do localities. The supervision and procedure
which may have been entirely successful in one locality may have entirely failed in
another. In one we may find a settled, thrifty, population, in another a sad admixture
of the migratory "ne'er-do-we'el" classes, occupants of single rooms, here today
and gone, no one knows whither, to-morrow, whilst perhaps an Anti-vaccination
League is in active operation scattering broadcast its opinions and prejudices, and
creating difficulties in the enforcement of the Act. It is equally unavailing to
stigmatize Boards of Guardians as "obstructives" and to assume that the presence of
small-pox in a district is unimpeachable evidence of the Vaccination Act not having
been efficiently worked. Whilst the compulsory requirement of the vaccination of all
children born after the passing of the Act will be generally admitted to have been a
step in the right direction it should not be taken for granted that society, composed
of all ages and conditions of people, will thereby, and at once, be exempted from the
terrible scourge of small-pox. If this desirable end is to be attained by vaccination
it can only be by an universal application of a compulsory Act to every individual,
adult as well as child ; but this the Vaccination Act does not even attempt.
In regard to infantine vaccination, I am of opinion that the Act of 1867 and its
machinery are seriously defective. In the first place much too long a period is
allowed to elapse before a case is brought under supervision. In many instances nine
or ten months elapse before the case comes under the notice of the Guardians under
sec. 10, and long before that time parents and child have probably migrated elsewhere,
leaving no trace behind them. A large proportion of the returned " defaulters''
in this district will be found to come within this category. Next, no legal means arc
provided for securing information of unvaccinated children. Sec. 31 does indeed
provide that the registrar or other officer may give information to a justice where ho
has reason to believe that a child under fourteen years of age is unvaccinated, but it
is not stated how the informant is to become "informed," and excessive zeal in this
direction would very likely lead to the unceremonious treatment not uncommon to
the "public informer." I will only further advert, without detail or comment, to the
difficulties which in some districts have already presented themselves upon its being
sought to enforce the Vaccination Act before justices.
It should moreover bo borne in mind that the half-yearly lists of "defaulters"
under sec. 16 extends only to children whose births have been duly registered, and
there is too much reason to conclude that a large proportion of the births in this
country are not registered at all, and consequently never come directly under the
notice of the vaccination authorities. This is unquestionably true to a very largo
extent in many of the metropolitan districts.
That the Vaccination Act of 1867 is not sufficiently comprehensive and its
machinery simple and perfect will, I think, scarcely bo questioned, and it remains to
be considered in what direction a remedy should be sought.
First, I am strongly of opinion that the registration of births should be made compulsory,
that medical practitioners, midwives, or nurses, in attendance at a birth
should be required within three days to give notice to the Registrar of the District,