Triennial Vaccination Report.
1. As vaccinations are performed in the hill tracts and in the feudatory State of
Manipur, the statistics in this report include the population of those regions, and are based
on the total population of the Province of Assam according to the census of 1901, viz.,
6,126,343.
Vaccination agencies.
2. The work was done by three classes of operators—the regular vaccinators, includ-
ing apprentices and licensed vaccinators; the Hospital
Assistants attached to dispensaries and their compounders,
who perform vaccinations at or near dispensaries ; and the medical officers and assist-
ants employed on tea gardens. The number of regular vaccinators (paid and licensed) is
in the proportion of 3.84 per 100,000 inhabitants, varying from 5.77 in Kamrup to 2.72
in Sylhet; and 6.06 per 1,000 square miles, varying from 11.21 in Sylhet to 2.86 in
Nowgong. The total number of operations done by all agencies, except military, during
the triennial period under review was 304,121 in 1902-1903, 278,802 in 1903-1904, and
298,102 in 1904-1905, as compared with 272,265, 271,466, and 280,827 of the previous
triennium. Thus it will be seen that 56,467 more operations were done in the last triennium,
and that vaccination has made progress in the province. The highest totals were in
Sylhet and Sibsagar and the lowest in Nowgong and Cachar.
3. In the first year there were 263 operators, in the second 245, and in the last
251. The average work of a vaccinator for the last three years was 999, 988, and
1,047. The increase in the total number of operations as well as in the work
done by individual operators in last year's figures results from the attention of civil
surgeons having been drawn to the unsatisfactory statistics of 1903-1904. The average
work of an operator on the paid establishment varied from 2,106 in Manipur to 461 in
Goalpara, and that of a licensed vaccinator from 820 in Goalpara to 576 in Sibsagar. One
reason why the licensed vaccinator does less work may be that he gets no travelling
allowance, and is therefore more confined in the area of his operations.
4. The total number of dispensary vaccinations fell from 22,597 in 1902-1903 to
21,078 in 1903-1904. Last season the number rose to 21,169. The greatest decrease
occurred in Nowgong, Cachar, and Darrang. The Civil Surgeon of Nowgong attributes
the decrease to the withdrawal of the special allowances to Hospital Assistants of dispen-
saries for vaccination work. The Civil Surgeon of Cachar is unable to explain the cause, and
the Civil Surgeon of Darrang attributes the decrease to the delay in the commencement
of the work on account of the late arrival of the lymph. The tea-garden staff vaccinated
18,696, 15,550, and 14,080, in the last three years, against a decennial average of 12,265.
The returns from gardens are partial and irregular.
5. Of the 298,102 operations performed in the last working season, 294,702 were
primary and 3,400 revaccinations, against 273,477 and 5,325 in the foregoing season, and
291,332 and 12,789 in the one before that. The ratio of protected persons per mille of
population was 48.18 in the first, 44.28 in the second, and 47.86 in the last year. The
prescribed diagram showing the death-rates from small-pox during the year 1904 and the
average proportion of the population protected during the last seven years is attached.
It indicates also the very high death-rate in Nowgong in 1904 and the very low death-rate
in Sylhet; and, if compared with the diagram in the last triennial report, the fact that the
proportion of protection has diminished in Sibsagar, Nowgong, and Goalpara.
Percentage of successful operations.
6. The percentage of successful primary operations for last season was 98.80. In
the previous year it was 97.87, and in the year before that
97.90. In primary vaccination six districts reported a per-
centage of 99, three of 98, and two of 97. The highest ratio (100.00) came from, the Khasi
Hills, and the lowest (96.33) from Darrang. The Civil Surgeon of Darrang cannot give
any satisfactory explanation of this low percentage of success. The percentage in the
case of revaccination ranged from 100.00 in three hill districts to 47.83 in Manipur.
The range in the case of revaccination must be great, because the susceptibility of the sub-
jects varies greatly, being usually in proportion to the length of time from the primary
operation. Some of the more ignorant count a second attempt at primary vaccination as
a " revaccination."
Vaccination work in different
districts.
7. Of the 13 districts, 7 show increase, and the rest decrease, in the total number of
operations performed. The decrease in Darrang is said to be
due to the illness of a vaccinator, the late receipt of the lymph,
and the incompleteness of the garden returns; in Sibsagar to
the non-receipt of returns from 14 gardens; in Lakhimpur to a falling off in the work
done in the tea gardens; in the Khasi Hills to an outbreak of cholera in the Jowai