5

6. Vaccination Staff.—The establishments employed in carrying
out vaccination comprise (1) the vaccination staff employed by district
boards and municipal committees ; (2) the special (provincial) staff of
vaccinators ; (3) the dispensary staff ; and (4) the cantonment staff.

(a) District Staff (Statement No. I).—The total number of opera-
tions performed by district board and municipal vaccinators during the
triennial period was 3,753,639, as compared with 2,893,786 during the
preceding triennium. Of this number, 2,258,348 were primary and
1,495,291 were revaccinations. these figures representing an increase of
276,417 primary vaccinations and of 583,436 revaccinations, as compared
with the preceding triennium.

In the case of primary vaccinations, every district in the province,
with the exception of Gurgaon, showed an increase, as compared with
the preceding triennium, the most conspicuous being Dera Ghazi Khan
(+39,876); Lahore (+27,927); Montgomery (+23,740); Muzaffargarh
( + 20,178) ; and Lyallpur ( + 19,800).

In respect of revaccination, all except five districts exhibited an
increase the most conspicuous being Dera Ghazi Khan (+ 132,939);
Kangra ( + 77,075); Gurgaon ( + 54,796); Amritsar ( + 40,093); and
Muzaffargarh ( + 39,891). During the year 1928-29 the total number of
persons vaccinated by district board and municipal vaccinators was
1,376,152, as compared with 1,226,579 in 1927-28 and 1,143.670 in
1926-27, the increase in the year under review, as compared with the
previous year, being 140,573.

Of the 1,376,152 persons vaccinated during the year 1928-29,
818,752 were primary vaccinations and 561,662 were revaccinations, these
figures representing an increase of 76,620 primary vaccinations and of
75,210 revaccinations. as compared with the previous year. All districts
of the province, with the exception of Kangra (—1,809) ; Mianwali
(- 689); and Multan (—602), showed an increase over the previous year in
the number of primary vaccinations, the most conspicuous being Dera
Ghazi Khan (+15,587) ; Hissar ( + 5,754) ; Karnal ( + 4,593) ; Gurdaspur
( + 4,364); Shahpur ( + 4,305); and Muzaffargarh (+4,261). In the
case of revaccinations, seven districts showed a decrease, as compared with
the previous year, the decrease being particularly great in the case of
Gurgaon (—27,366) ; Muzaffargarh ( — 9,456); and Sheikhupura (—8,063).
The districts showing a conspicuously large increase were Dera Ghazi
Khan ( + 40,673) ; Kangra, ( + 9,683); Ludhiana +9,506); Rawalpindi
( + 9,431); and Ferozepore ( + 9,285). The best vaccinated districts, as
judged by the average annual number of persons successfully vaccinated
during the past five years per 1,000 of population, are: Kangra, 62.88
per mille ; Muzaffargarh, 60.36 per mille ; Mianwali, 58.55 per mille;
Gurgaon, 58.16 per mille ; and Dera Ghazi Khan, 55.90 per mille. The
various causes which have contributed to the increase are the same as
those mentioned in paragraph 5. The large decrease in the number of
revaccinations in the Gurgaon district is due to the fact that the intensive
campaign conducted in the previous year was not continued and the
additional staff engaged for the purpose was discharged.

(b) Municipal Staff.— In the case of towns, the total number of
operations performed by municipal vaccinators during the year under
review was 146,032, of which 82,223 were primary and 63,809 were
revaccinations, the corresponding figures for the preceding year being
121,070 (74,131 primary and 46,939 revaccinations) and 132,660 (72,582
primary and 60,078 revaccinations) during the year 1926-27. The
figures for the year under review, therefore, show an appreciable increase,
in the case of both primary and revaccinations, as compared with the
two preceding years.

Smallpox is, however, nearly twice as prevalent in towns as in rural
areas, and the arrangements for vaccination in municipal towns leave
much room for improvement. All municipal towns have now adopted the
Vaccination Act. but many have still to make regulations under the Act,
without which it is difficult or impossible to enforce it. But, even when
regulations have been made, they are often a dead letter. The average