3
During the year under report 177,286 primary operations and 294,729
re-vaccinations were performed as compared with 178,698 and 277,553,
respectively, in the previous year.
6. Protection of infants.—During the year under report the number of
children under one year available for vaccination was
1,080,668 and
the number of successful operations was 417,112 equal to 386 per
thousand against 378,345 or 356 per thousand successful operations out of
1,063,708 children available during the previous year. The protection of
infants in municipalities is separately shown in statement VII. It gives
a ratio of 540 per thousand of the surviving infant population as compared
with 570 in the previous year.
These figures are unsatisfactory inasmuch as they show that far more than
half of the total number of operations is performed on children over one year
of age. Civil Surgeons and Assistant Directors of Public Health are unani-
mous in attributing the opposition to vaccination to be concerned more with
the age of the child than with the operation itself, as there is a strong
prejudice against vaccination of infants at an early age. The advantages in
retaining the limit of age for compulsory primary vaccination as it now
stands are obvious, but prejudices in India die hard and it will take years of
education to dispel this one.
7. Incidence and mortality of small-pox.—During the last ten years, the
total number of deaths from small-pox in the districts of this province has
been 128,998.
During the first quinquennium the number of deaths was 55,691, and
during the second 73,307. In each of the last five years the mortality was
as follows :—2,695, 3,893, 8,345, 22,748 and 35,626.
This shows a progressively increasing annual total, but does not necessarily
mean that this steady increase is going to continue. Small-pox is endemic in
the province, and will continue to be so until and unless vaccination and
re-vaccination are made compulsory.
Epidemics of the disease occur at
intervals of about five or six years and at these times the number of both
primary and secondary vaccinations done increases. The epidemic persists in
varying intensity for two or three years and then dies out, but small-pox still
continues in endemic form. At the end of another five or six years there is
a recrudescence and it appears in epidemic form again. In 1926 we were at
the height of the epidemic and there are already signs of its lessening in most
of the districts.
The provincial ratios of the mortality from small-pox per thousand of
population during the last five years have been 0.07, 0.11, 0.24, 0.67 and 1.05.
8. Prevention of small-pox.—The statistics given in the previous para-
graphs indicate the insufficiency and inefficiency of the existing arrangements
for vaccination, and it almost appears as if we relied more on natural causes
to eventually arrest an epidemic, than in our efforts at prevention by
vaccination.
Small-pox is a preventible disease and vaccination can prevent it, as it
has in countries where it is properly carried out. In the light of this
knowledge and in face of the above facts there is a great necessity for
a stronger and more complete vaccination policy.
The question of compulsory vaccination throughout the province has been
under consideration for some time and primary vaccination has been and is
being extended to whole districts and areas in districts. Difficulty is still
being experienced in certain areas and amongst certain classes notably the
Brahmans, Rajputs and Bunniahs and in some cases the Muhammadans, of
almost every district, and where these difficulties become acute, the
Vaccination Act is extended on application from the district officials.
But the process is a slow one, and the time has now come when vaccina-
tion should be made compulsory throughout the province and should be free.
Compulsory primary vaccination alone, although it will be beneficial, will not