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45.34 per cent. of the boys escaped vaccination altogether. The children
with small-pox marks are, however, the survivals and estimating the
mortality incidence to case incidence in such children as 35.35 per cent.
the figure of 16.67 per cent. representing children with small-pox
marks denotes that 25.45 per cent. had contracted the disease. The actual
percentage of school-going class which escaped vaccination at birth was
therefore 54.12 per cent.
In the municipalities, out of 5,045 children seen in towns, 21.25 per
cent. had no vaccination marks and 14.33 per cent. had small-pox marks ;
so, allowing for deaths, 43.38 per cent. of the children of school-going
class escaped vaccination at birth.
II Range.—The general finding as far as this range is concerned, is
that at least one-third of all children born evade vaccination in infancy,
while in certain districts the percentage of such children is very much
higher. In Unao the percentage of unvaccinated school children was
about 70 per cent., while in Sitapur it was 50 per cent. A very large
number of these children, both in Unao and Sitapur, were found protected
by small-pox, leaving the unprotected school population to be dealt with
by vaccination at roughly one-third of the whole.
The districts under the district health scheme showed a relatively
higher degree of protection.
III Range.—The percentage of non-vaccinated children in municipal
schools where the Vaccination Act is compulsory was 22.27 and in the
district schools 45.8.
IV Range.—The percentage of unprotected children in the district
board primary schools ranged between 34.9 and 3.9.
The conclusion drawn from the facts stated above is that the vacci-
nation state of the school children in these provinces is far from satisfactory
and that the necessity for vaccination and re-vaccination of all unprotec-
ted or poorly protected school children cannot be too strongly urged.
It is reported that in some cases the school authorities are averse to take
action in this direction for fear of a fall in attendance.
I would therefore suggest that admission to any school aided by
public funds be forbidden unless a certificate of protection against small-
pox is tendered by the scholar and that headmasters be made responsible
for this. It will go a long way if orders on the subject are issued to the
educational authorities by the Director of Public Instruction, United Prov-
inces, as a central authority instead of by divisional inspectors of schools.
These recommendations, if carried out, will, however, be of value in
protecting school children from small-pox ; they will have no effect, how-
ever, in improving the grave state of affairs disclosed by these inspections
which tend to prove that between 40 and 50 per cent. of boys belonging
to families who are likely to send their children to school evade vacci-
nation during the first year of life. I would point out that in all
probability this very large percentage of unprotected children does not
exist among the menial classes who do not as a rule send their children
to school. I and my Assistant Directors have repeatedly noticed during
our inspections that well over 90 per cent. of the children produced for
inspection belong to the menial classes and we have always attributed
this to the fact that the menial classes are not aware that vaccination is
voluntary and only require the order of the vaccinator to get their
children vaccinated. The better classes are quite aware that vaccination
is voluntary and therefore refuse to have their children vaccinated.
The only method of bringing this unsatisfactory state to an end is the
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