Vaccination.—

                                                                        Triennial report on vaccination in
                                                                              the Bombay Presidency for the
                                                                              years 1911-12, 1912-13 and 1913-14.

                                                No. 9122.

                                                                  GENERAL DEPARTMENT.

                              Bombay Castle, 11th November, 1914.

Letter from the Sanitary Commissioner for the Government of Bombay, No. 6006,
dated the 24th September, 1914—

Submitting the triennial report on vaccination in the Bombay Presidency for the
years 1911-12, 1912-13and 1913-14.

RESOLUTION.—In regard to the number of persons primarily vaccinated
the last two years of the triennium, the results for which approximate
very closely to one another, show a distinct improvement over the first. Even
with the reduction produced by the inclusion of the latter year's results, the
average of the triennium under review, 704,427, exceeds the average of the
preceding triennium by 37,930. As the latter represented an improvement of
67,267 on the results of the triennial period 1905—08, it is apparent that there
has been steady progress in the spread of vaccination in the Presidency.

2.    The complete ascertainment of the results of vaccinations still presents
considerable difficulties, and the percentage of cases regarding which information
was not obtained increased slightly from 7.59 in the previous triennium to 8.28
in the triennium under review. The nomadic habits of certain classes of the
general community constitute the principal difficulty in this respect.

3.    Re-vaccination, which is essential for the prevention of small-pox, is making
only slow progress, in spite of the increased activity during recent years of the
disease, every fresh outbreak of which gives a temporary and local stimulus to
re-vaccination. The annual average number of re-vaccinations during the
triennium was 71,003, a figure which the Sanitary Commissioner rightly regards
as altogether inadequate, having regard to the adult population of the Presidency,
for the effective stamping out of small-pox. The great mass of the people have
still to learn to appreciate the preventive value of this operation.

4.     The output of doses of glycerinated vaccine from the Belgaum Vaccine
Institute increased from 635,000 in the concluding year of the preceding triennium
to 874,000 in the corresponding year of the triennium under review. The recent
introduction of cold storage, which admits of the lymph being prepared in large
quantities during the most favourable season of the year, has resulted in a marked
improvement in the quality of the material. In Sind where, during the preceding
triennium, all operations were carried out with human or animal lymph, more
than half the cases are now treated with the vaccine. Climatic conditions and
the inexperience of operators still tend, however, to keep down the proportion
of successful operations in that province. The Governor in Council observes
that in the Presidency circle also the percentage of success is low, lower in fact
than in any other registration district, a point regarding which the report offers no
explanation.

5.    The Deputy Sanitary Commissioners travelled over immense distances in
the performance of their duties in connexion with the supervision of vaccination.
It cannot be doubted that the constant rapid moving which this portion of their
work necessitates is prejudicial to the proper discharge of their more essentially
sanitary functions, which requires that they should have time to make a careful
and exhaustive study of the sanitary conditions and requirements of the principal
urban centres in the areas under their control. This disability constitutes
one of several important considerations which have been advanced in support of
a proposal, now before Government, to appoint District Health Officers, who would,
among other duties, relieve the Deputy Sanitary Commissioners of their routine
work in connexion with vaccination. The creation of such posts would have the

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