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13
duration of the protection is limited, since all experience goes to show
that the duration of protection is proportionate to the number and area
of cicatures produced," it may still be a mistake to insist in all vaccinations
on four "insertions." I believe it is a mistake. It could
be made quite clear that the period of protection is a small one if one
"insertion" only is made, and the process could be called a 'partial'
or ' semi' vaccination to distinguish it from the ordinary process.
The present method results in an absolute immunity for a period
of seven years, and the protection which results may prevent a severe
attack in the majority of instances throughout the whole of life; but it
is desirable that the process of vaccination should be made as mild as
possible where this is desired even though the period of immunity is
considerably diminished. Vaccination by a single incision of half an
inch in length insufficiently deep to draw blood and avoiding injury to
the tissues by scratching will confer immunity for a sufficiently long
period for most purposes—certainly for twelve months at a time that
Small-pox is present in the form of an epidemic, and this milder form
of vaccination produces no ill-effects. There would be less difficulty
in obtaining consent to vaccination if this milder method were permitted
by public vaccinators as an alternative to the present method, and from
the mildness of the operation there would not be any objection to revaccination
if the presence of Small-pox warranted re-vaccination.
There may be some other details in which the operation might be improved,
as for instance, the abandonment of the use of adhesive
plaster to retain the dressing, as the plaster may cause irritation of
neighbouring skin, although for hurried vaccination and ease of procedure
these plaster strips are, of course, very convenient.
There is a growing body of opinion that the compulsory sections
of the Vaccination Acts lead to opposition and in any case only result
in the vaccination of a proportion of the infant population, the least
exposed to infection and least capable of spreading any disease. Also
it is absurd that persons who do not wish their children vaccinated in
infancy at a time when it may be perhaps most inconvenient or even
ill-advised from a health point of view, should have no other alternative
than signing an objection form, as the existing power of postponement
is inadequate. Possibly some power under which persons
who have been exposed to the disease and who refuse to take precautions
to protect themselves by accepting vaccination could be held
responsible if others are infected by them, would have a better effect
in ensuring vaccination when it is necessary, than the present system
of compulsorily vaccinating infants. It should also be possible to
enforce the isolation of unvaccinated contacts without compensation
for loss of work.
The present system is unsatisfactory, in my opinion, from several
aspects, not only as regards the administrative point of view, but in
its results.