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14
one's views may be about the vaccination of the entire population, no
one with any knowledge of the protective power of vaccination can
fail to advocate that all who are exposed to infection should obtain
protection. A person who is exposed to infection should not be permitted
to infect his neighbours. There should be no freedom to spread
infectious disease and to cause loss to the community and ill health
through one's own selfishness. One such unvaccinated person,
through turning up to work at a factory in a neighbouring Borough,
infected several others, until finally 45 of the workmen had been admitted
to hospital, thereby seriously hindering for a time the working
of that factory.
The view of the authorities in foreign countries with regard to
the unvaccinated state of the population of England was shown clearly
by the action taken fairly recently by France as regards English travellers
to that country. It cannot be good for the trade of the country
that England should be regarded as the home of smallpox, and to
suggest that smallpox exists in other countries but that the medical
men of those countries stultify themselves, as has been suggested, by
ignoring the nature of the disease, is ludicrous. It is ludicrous from
the point of view of the actions at law that might result, if from no
other reason.
In my report to the Public Health Committee on December 31st,
1929, I emphasised the following points:—
1. Vaccination can be made a safe and harmless operation, that is
to say, when care and cleanliness are observed. A modified form is
now permitted by the Ministry of Health.
2. Vaccination has become more feared than the disease from
which it protects—smallpox—and contacts prefer to run the risk of a
mild attack of smallpox than undergo vaccination.
3. The public will require enlightenment as to changes of methods
of vaccination, results, value of vaccination, before confidence can be
regained.
4. It is an absolute impossibility to eradicate smallpox in the
absence of vaccination once the number of cases prevents supervision
of contacts during the later days of the incubation period. This present
type is mild, and its infectivity is low as compared with the Asiatic type,
and the number of cases will fall when the winter is over, but under the
present circumstances there appears to be no adequate reason why
smallpox should not become as endemic as measles. We cannot stamp
out measles, we have no sure specific remedy. We can stamp out smallpox,
a sure specific remedy exists, but the community prefers not to use
it. There is also this to be remembered, that the introduction of severe
smallpox among a community in which the mild type is out of control,
will obviously result in an epidemic of appalling severity, as there is no
means of differentiating between the mild type of smallpox, which some
observers say breeds "true," and the mild infection from a severe type
of case which, although it may give rise to a mild attack in a particularly
insusceptible person, gives rise to a severe attack of severe type as
regards ordinary contacts.