2
It will be seen that the number of successful primary vaccinations
during the triennial period under review shows an appreciable increase
over the figure for preceding triennial periods. The figures for the
triennial periods 1917-20 and 1920-23 were, however, distinctly smaller
than those of the immediately preceding triennia. Thus, from the year
1917 to the year 1922, as. the result of the war, and of the non-
co-operation movement which followed it, an appreciable decline in
the annual number of vaccinations took place. It was, in fact,
not until the year 1923-24 that vaccination regained its pre-war level.
From this year onwards slow, but steady progress has been made, with
the result that the figures for the triennial period under review exceeded
the corresponding figure of the preceding triennium—hitherto a record—
by 76,692, whilst the figure for the year under review (1928-29)
exceeds the record figure of the previous year by 78,793. The triennial
figures are as follows: —
1926-27 ... ... ...
1927-28 ... ... ...
1928-29 ... ... ...
6,57,036
7,05,169
7,83,962
Progress has been even more rapid in the case of revaccination,
the mean figures for the triennial period 1926-29 being 564,908 as com-
pared with 342,382 during the preceding triennial period. That this
progress has been more than maintained during the year under review is
shown by the fact that the number of revaccinations was 645,673, which
is 118,383 in excess of the corresponding figure—hitherto a record—of the
previous year. But, although these figures, both in respect of the triennial
period and of the year under review, show a substantial and gratifying
improvement, both in primary and revaccination, it is not expedient to
rest satisfied with recent progress or to regard the present position with a
sense of complacency. In the first place, the population contains, as the
result of the decline of vaccination during the war and the post-bellum
period, a relatively large number of unprotected adults. Secondly, owing
to the high birth-rate and low infant death-rate during the past three
years, an abnormally large number of susceptible individuals has
recently been added to the population; and, finally, the unusual prevalence
of smallpox during the past few years has rendered it clear that virulent
epidemics can and do still occur with great readiness.
Indeed, the spur occasioned by the recent prevalence of smallpox
is responsible in large measure for the increase in the number of re-
vaccinations during the year under review. In these circumstances it is
clear that, if epidemics of smallpox are to be avoided, and if many
unnecessary deaths, both of adults and of children, are to be prevented,
an effort must be made to increase greatly the number of primary
and revaccinations performed each year. Nevertheless the substantial
progress made during the triennial period under review provides not only
evidence that the scheme outlined in paragraph. 5 of the Notes on
Vaccination for the year 1924-25 has been attended with success, but
it justifies the hope that the prosecution of this policy will be attended
with an even greater measure of success in future.
One of the most important features of this policy was the adoption,
in the case of rural areas, of the thanewar system of vaccination, and the
provision of a register in which the vaccination state of each village (and
its vaccination index) can be recorded. It is now clear thatone vaccinator
per thana is not sufficient if due provision is to be made for revaccina-
tion, but Medical Officers of Health are unanimous that a great improve-
ment in vaccination has followed upon the introduction of this scheme.