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APPENDIX A.
Annual Report on Vaccination in the 1st Circle by Brigade Surgeon Lieutenant'
Colonel R. JAMESON, M. D., Deputy Sanitary Commissioner.
The season began on the same date as last year, viz., the first October, all vacci-
nators having been directed to be at their posts on 20th September, but it was continued
in all districts, except Muttra, till 15th April. Circular No. 234 of 26th February
1894, directing vaccination to be continued till 15th April was overlooked in Muttra
and work in that district ceased as in former years on 22nd March.
The result of the season's work is satisfactory on the whole, primary successful
vaccinations having increased by 52,445, from 255,726 to 308,171. On the other
hand re-vaccinations show a decrease of 3,073 operations.
All districts except Dehra Dun and Tehri Garhwal contributed to the increase in
primary vaccinations. In the former there is a decrease of 68 and in the latter of 232.
The districts which show most increase are Bulandshahr 6,483, Aligarh 8,341, Agra
4,849, and Etah 9,830. The high birth-rate of the year and the lengthened period
during which vaccination was continued, account for much of this increase. The great
increase in Etah is particularly satisfactory, for hitherto this district has been one of the
most backward in the circle. An increase of two vaccinators was made to the district
staff from 1st October, but it is to the Collector of the district, Mr. Galbraith, that
this excellent result is principally due. Mr. Galbraith directed all patwaris to make out
a list of all children unvaccinated in the village or villages in their jurisdiction. They
were also to try and persuade the best families in these villages to lead the way by
having their children vaccinated. This list and this assistance have had the excellent
result mentioned.
The decline in re-vaccinations is almost as general as the increase in primary vacci-
nations. Muzaffarnagar, Meerut and Etah show an increase compared with last year of
141, 69 and 251, all the other districts show a decrease of from 72 in Etawah to 1,050
in Tehri Garhwál. In Tehri Garhwál it was observed that among the re-vaccinations
were many old people, 40 years of age and upwards. These were mostly unsuccess-
ful and such work only swelled the records without advantage. Hence, the decline
in Tehri. In the plains re-vaccination is not yet popular and children of 8 years and
upwards disappear very quickly at sight of a vaccinator. Moreover, the lymph used
in re-vaccinating does not renew itself, no points being filled from such cases. It is
only, therefore, when lymph is abundant that it can be spared for re-vaccinations.
Making all Civil Surgeons, District Superintendents of Vaccination within their
districts has had in most cases the excellent result of also enlisting the district staff in
aid of vaccination. The whole district staff are now more or less interested in the pro-
gress made. To counterbalance this good, municipal and local vaccinators have been
in many cases prohibited by municipal and local authorities from working beyond the
limits of those municipalities and towns from which they are paid. Vaccination
stations also limit the usefulness of vaccinators. The vaccinator must be present in
the appointed place at certain hours, usually all the morning and forenoon, whether
children are brought to be vaccinated or not. Formerly all villages with a radius of
from 3 to 5 miles of a municipality or the Headquarters of a local vaccinator
were within his jurisdiction. A smaller staff of Government vaccinators then sufficed
for the rest of the district than now. Where municipal and local vaccinators are nu-
merous, as in Meerut, the Government vaccinators are unable to take up these vacant
localities in addition to their own circles. Prohibiting municipal and local vaccinators
in small towns from vaccinating beyond the limits of such towns, is advantageous to no-
body but the vaccinator. If this prohibition be continued it will be necessary to increase
the number of Government vaccinators in such districts, or have parts of them vac-
cinated once in two years only.