( 2 )
the disease broke out in an epidemic form vaccination had to be temporarily
stopped and vaccinators were supplied with medicines and employed on itinerating
medical work. Besides, a considerable proportion of children was incapacitated for
vaccination by the disease. In several districts there was a dislocation of work
owing to the illness of a large number of vaccinators. Plague, cholera and
relapsing fever were also responsible for the decrease in some cases. Re-vaccina-
tion returns show an increase of 34,176 over the previous year's figures, but this
is due to the fact that a large number of operations was performed owing to the
outbreak of small-pox in many places. The importance of re-vaccination as a
preventive against small-pox cannot be over-estimated. The district authorities
should, therefore, take all possible steps to encourage this wholesome measure.
The inconvenience resulting from re-vaccination is generally very slight and
people can generally carry on their ordinary work without interruption after
re-vaccination. Thus there is no excuse for avoiding re-vaccination. The
average number of persons vaccinated by each vaccinator in 1918-19 was 1,535,
against 1,833 in 1917-18 and the percentage of successful cases, in which the
results were known, was 97.09 in the case of primary and 65.56 in the case of
re-vaccination during the year under report, as compared with 97.40 and 72.50,
respectively, in the preceding year.
Successful primary vaccinations
in different districts.
(Statement I.)
5. There was a general decrease under this head throughout the
Provinces during the year under report, as compared
with the preceding year, except in the districts of
Almora and Mirzapur which show an increase.
Compared, however, with the provincial average (25,357) of successful primary
vaccinations in different districts, 21 out of 48 districts show an increase. Of
these Gorakhpur heads the list with an increase of 64,280, followed by Basti with
an increase of 26,726, Meerut of 16,871, Jaunpur of 10,853, Bulandshahr of 8,353
and Moradabad of 7,694. The districts returning a low number of successful
primary vaccinations are Dehra Dun (4,324), Naini Tal (6,516), Muttra (13,197),
Jalaun (13,599) and Garhwal (14,001).
Successful vaccination and degree
of protection afforded.
(Statement I.)
6. The number of persons successfully vaccinated by the district staff
was 27. 84 per mille of population during 1918-19,
against 33.95 in the preceding year.
Almora
heads the list of the well protected districts with a
rate of 54.37, and is followed by Garhwal with a rate of 48.75, Jhansi of 40.53
and Mirzapur of 38.23. The most conspicuous of the least protected districts
are Allahabad (17.51), Partabgarh (19.41), Mainpuri (20.64), Muttra (20.90) and
Agra (21.11).
Vaccination in proportion to
births and according to age.
7. The percentages of successful vaccination in proportion to births show
a decrease under all heads in 1918-19, as compared
with the preceding year, the ratios for the two years
being 43.75 and 48.69 in the case of children under one year, 18.47 and 19.06
in the case of children of one and under six years and 65.17 and 70.29 for all age
periods, respectively. The decrease is attributed to high mortality among
children.
An examination of the figures of the different ranges shows that 53.06
children under one year of age were successfully vaccinated per 100 births during
the year under report in the first range, 35.75 in the second range, 43.63 in the
third range and 40.85 in the fourth range, against 61.92, 38 07, 48.73 and 42.86,
respectively, in the preceding year.
Mortality from small-pox.
8. The mortality registered from small-pox in 1918 was 2,908, equivalent
to a death-rate of .06 per mille, against 2,011 and
'04 in 1917, the mean ratio of the previous five years
being .13.
Diagram.
9. A diagram showing the relation between the mortality from small-pox
and the protection afforded by vaccination in each
district is attached.
Dispensary vaccination.
(Statement III.)
10. During the year 1918-19, 933 vaccination operations (208 primary and
725 re-vaccination) were performed at the dispen-
saries in these Provinces, against 143 in 1917-18,
showing a marked increase of 790.