1913 BMJ (Clinical Research Edition)  
and Dysart gives details of 43 cases. Of these, 31 were known to have been vaccinated and 12, including an infant infected prior to birth, were either unvaccinated or showed no vaccination scars. There were 13 deatlhs. Six were patients who showed evidence of vaccination. Of these 2 -were females, aged 50 and 52 years respectively, not vaccinated since infancy, onc male aged 47, vaccinated in infancy, and another 'Malc aged 37, wlho had been revaccinated twenty-tllree years previously. The
more » ... reviously. The remaining 2 cases were females whlo botlh died in puerperium) 1 aged 23 -with two vaccination scars, the otlier aged 33 with ono vaccination scar. Seven deatlhs occurred in person's wlho showed no evidence of vaccination. Of these, 2 males, aged 47 and 46, were registered as lhaving been vaccinated in infancy, but no vaccination scar was found. An infant now known to lhave been infected with small-pox before birth was vaccinated wlhen two days old and died six days later after the small-pox raslh lhad appeared. Excluding 3 cases revaccinated witlhin nine days of infection with small-pox, only 1 revaccinated case (and that revaccinated over tw,enty years before) occurred during the outbreak. A number of per-sons were infected who refused theoffer of vaccination or revaccination. An-analysis" of the vaccinated cases reveals-thc striking fact that in no single instanee--were there four scars..-Of the 31 vaccinated cases, 13 showed only onescar, 16 only two, and 2 showed three scars. A hiaher standard of vaccination is distinctly indicated than that o-btained in the bulk of these cases. Very careful observations lhave been recorded regarding tlle vaccinal condition of the cases in the IKirkealdy outbreai. The antivaceinators have agitated for this, but the details fully m-aintain the claims advanced for vaccination. It is unfortunate that certificates of "' successful" vaccination should be issued, as has frequently happened, since the consequences tend to produce an altogether erroneous impression in the minds of antivaccinators and otlhers. There exists a uniformity in the. certificates, but by no means a uniformity in thevaccinations. There are many cases recorded in which certificates have been given without inspection, and the case for vaccination suffers by this, and there are other indications of laxity in regard t4 vaccination certificates. If certificates are to be taken as. proof of vaccination the greatest possible care is essentia. It lhas been suggested that thle certificate should contain a statementas to the n-umber of insertions made and the number of vesicles obtained.-In the case of puiblic vaccination this information is, iecorded in the register, but these details are not provided in privhte vaccination. The Kirkealdy out-
doi:10.1136/bmj.1.2716.138 fatcat:2azp2hscgbd7vcvcaeyr5fhv6i