If the vaccinator assumes that all of the people who revealed immune reaction have enough immunity to smallpox, he may be misled about the state of resistance, unless he used potent vaccine and payed much attention to the local resistance of the site of inoculation, he might have inoculated on the most resistant area. There are evidences that at the sites of previous vaccination a local immunity may develop.
In order to investigate the relationship between the site of inoculation and the rate of successful results, we divided 114 students in two groups and vaccinated the one on the left forearm and the other on the left upper arm. Table 1 shows the rate of successful results of the both groups. The rate of successful responses of the former group is 30-40% higher than that of the latter.
Then, 119 children received two scarificatioris on the left forearm and two on the upper arm. As seen in Table 2, the rate of successful results on forearm is much higher than that of upper arm. Table 3 shows hat out of 30 children reacted immune on the upperarm, 23 received successful vaccination on the forearm. The contrary. example never existed. So, many of the immune reactors on the upper arm are, so to speak, pseudo-immune reactors and should not be considered to have enough immunity.
The rate of successful results of the forearm vaccination with potent vaccine was more than 80%.
Today, as smallpox has been successfully controlled, the medical profession has become so neglectful of vaccination that many of the people have not enough immunity to the disease. There is a danger of spread of smallpox in such a state of mass immunity, if the disease is introduced in the country.
Summary. It is preferable to avoid the sites of previous vaccination, for there are evidences of local immunity as we have shown in this paper. Forearm vaccination with potent vaccine is recommended as the most effective mass immunization against smallpox. (See page 60-64.)
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