3
at an early age. I consider that it is desirable that the Vaccination Act should
be amended so as to raise the age for compulsory vaccination to one year
instead of six months.
7. Incidence and Mortality of Small-pox.— During the last ten years the
total number of deaths from small-pox in the district of this Province
has been 96,128.
During the first quinquennium the number of deaths were 40,437 and
during the second 55,691. In each of the last five years the mortality was
as follows:— 6,687, 6,205, 18,514, 19,374, and 4,911.
The provincial ratios of the mortality from small-pox per thousand of
population during the last five years have been .19, .17, .53, .56 and .14.
8. Prevention of small-pox.— The constant and considerable mortality
noted in the preceding paragraph is, in my opinion, a complete demons-
tration both of the insufficiency and of the inefficiency of the existing arrange-
ments for vaccination.
It is well known—in fact it is an admitted axiom—that thorough vacci-
nation can and does stamp out small-pox altogether, and in the light of that
knowledge, and in face of the above facts, there is great necessity for a more
definite vaccination policy.
I do not consider that small- pox can be effectively dealt with and
stamped out unless vaccination is made compulsory throughout the Pro-
vince, and I would recommend that the Vaccination Act should be modified
so as to extend the age within which vaccination is required, to one year,
and should be generally enforced; that vaccination should be free; and
that the supervision and control of vaccination should be delegated to District
Boards and Municipalities and their Health Officers.
9. Inspection of Work.—During the year under report the Assistant
Directors of Public Health inspected 61,401 primary vaccination as against
145,627 in the previous year. The decrease is due to the inspections being
made in greater detail in the villages and to the inclusion of the spleen census
amongst village children in the cold weather vaccination inspection tours.
The inspecting work done by the Assistant Directors of Public Health
has been comprehensive and they have submitted valuable reports on the
efficiency of the staff and work in 17 out of the 21 districts in the Province.
The Civil Surgeons of the Province inspected 31,207 primary and 8,600
re-vaccination operations against 53,177 primary and 9,047 re-vaccination last
year. It should be noted that the methods of inspection of Civil Surgeons and
Assistant Directors of Public Health are different. Civil Surgeons inspect the
new work which has just been done and the numbers returned by them are
therefore smaller, whereas Assistant Directors of Public Health inspect all the
children under ten years of age, and look at old work as well as new work and
also look for unvaccinated children and children who are marked with small-
pox, and they also examine vaccinators' registers and other records in the
villages where they can be verified and checked.
10. Supply of Vaccine.—The Vaccine Depôt at Namkum supplied the
province with vaccine throughout the year. A large supply of vaccine is held
in reserve and the necessary stores and supplies for manufacture are in
ample stock. Fifty-five lakhs eighty-nine thousand nine hundred and
thirty doses of vaccine were manufactured during the year as compared with
1 ,869,908 doses last year. The number of doses issued was 2,679,298 against
2,628,548 in 1920-21. The number of doses in stock at the end of the year was
4,100, 366. The number of calves used during the year was 957 as compared
with 362 in the previous year, and the average yield of crude vaccine was
over 58 grammes per calf as compared with 55 grammes in the previous year.
The working cost of the. Depôt for the year amounted to Rs. 28,879 as com-
pared with Rs. 24,923 in the previous year. The average cost of the vaccine
per dose works out at .99 pies on the gross expenditure and to .29 pies on the
net expenditure when the receipts are taken into account.