Notes on Vaccination in the North West
      Frontier Province for the year 1927-28.

      REVIEW BY THE CHIEF COMMISSIONER.

The total number of vaccinations performed in 1927-28
was 200,632 against 185,957 in the preceding year. This
increase is distinctly satisfactory, as it was not necessitated
by any corresponding increase in small-pox. Indeed,
small-pox played considerably less havoc in the year under
report than in 1926-27, the number of deaths from this
disease during the year 1926-27 and 1927-28 being 466 and
161 respectively. The decrease in mortality in Dera Ismail
Khan District was particularly remarkable, there having
been only one death from small-pox against 285 in the
previous year. Yet Dera Ismail Khan records a satisfactory
increase in the number of vaccinations performed.

The number of persons vaccinated in political agencies,
however, fell from 33,644 to 24,238. Though, at first sight,
disappointing, this decrease is largely explained by the fact
that small-pox was not prevalent in the agencies in an
epidemic form. Nor did all the agencies contribute to
this decrease. Both the Waziristan agencies and Kurram
record an increase in the number of persons vaccinated. It
is only in the Malakand Agency, particularly Chitral, and in
the Sherani Country that there was a decrease.

The average number of operations performed by each
vaccinator rose from 4,952.32 to 5,135.20. As in the last
year, Hazara District heads the list with an average of
7,394.14. It is satisfactory to note that Dera Ismail Khan,
which, in 1926-27, was at the bottom of the list with an
average of only 3,317.80, now stands second with an average
of 6,250.00. Peshawar District shows the smallest average
of work done by each vaccinator, namely 4,577.17.

Another satisfactory feature is that the ratio of
successful vaccination per 1,000 of population increased
from 46.06, the average for the preceding five years, to
55.08 in the year under report.