PNEUMOCOCCAL VACCINES 495 



after vaccination, no cases of pneumonia of the three specific types 

 developed among the men who had received two or more injections, 

 whereas there occurred twenty-six cases due to pneumococci of the 

 same types among the nineteen thousand or more unvaccinated sol- 

 diers. The case mortality of all types of pneumococcal pneumonia 

 among the vaccinated was 11.7 per cent against a mortality of 

 28.0 per cent among the unvaccinated troops. 



The results following the use by Cecil and Vaughan 216 at Camp 

 Wheeler of lipovaccine in a single dose containing approximately 

 ten billion each of pneumococci of Types I, II, and III were not so 

 striking as those at Camp Upton. Men representing 80 per cent of 

 the camp strength — a total of 13,460 — received the vaccine treat- 

 ment and among them, during the two or three months following 

 the injection, thirty-two cases of pneumonia caused by the first 

 three types of Pneumococcus developed, whereas among the unvac- 

 cinated soldiers, comprising one-fifth of the whole group, there 

 were forty-two cases in the same period. The death-rate from all 

 pneumonias due to different types of pneumococci occurring 

 among the vaccinated men one week or more after the single in- 

 jection was 12.2 per cent, whereas among the unvaccinated control 

 subjects the percentage was 22.3. Of the primary pneumonias 

 among the vaccinated troops, the fatality-rate was 11.9 per cent 

 as compared to 31.8 per cent in the case of the untreated men. In 

 their deductions from the records, Cecil and Vaughan suggested as 

 possible causes for the less favorable results the fact that at Camp 

 Wheeler many of the soldiers were raw recruits, a large part of 

 whom were Negroes of rural origin, whereas at Camp Upton the 

 men were largely white recruits from New York City and were well 

 seasoned at the time of vaccination. The authors made no refer- 

 ence to the part which the use of lipovaccine instead of saline bac- 

 terial suspension or the single injection as against two or more in- 

 jections may have contributed to the less favorable experience. 



In regard to the use of lipovaccines, the report of Rosenow and 

 Sturdivant (1919) 1173 may be quoted. Three subcutaneous injec- 



