VACCINATION. 741 



and surgical care of the wound. As a rule vac- 

 cination in man protects against smallpox for a 

 period of six to ten years, after which revaccina- 

 tion is necessary for continued protection. It 

 should not be concluded from the negative out- 

 come of a single vaccination that the individual is 

 immune to vaccination and hence immune to 

 smallpox, but rather, repeated attempts should be 

 made with virus known to be fresh. It is quite 

 possible that certain individuals are immune to 

 vaccinia, as often stated, but they are very rare, 

 and the condition should not be recognized hastily. 

 Among 38,000 vaccinations Dr. Cory encountered 

 but one in which a "take" could not be obtained 

 on second trial (Abbott). 

 The ideal condition is that all children should when to 



. -, . -, , . Vaccinate. 



be vaccinated at an early age by requirement of 

 law as in certain European countries, where it is 

 demanded within the first few months or the first 

 year or two of life. Some countries require re- 

 vaccination before the children are admitted to 

 school and recommend repetitions at suitable in- 

 tervals. 



We have no national law on the subject and the 

 state laws differ. In many states children must 

 be vaccinated before they are admitted to the pub- 

 lic schools, the responsibility sometimes falling 

 on the school and sometimes on the city or town 

 authorities. A number of states have no laws on 

 the subject, although vaccination is for the most 

 part assured through the requirements of the 

 state boards of health and the local authorities. 



When there is danger of an epidemic", and in 

 known cases of exposure, vaccination should be 

 practiced thoroughly. Inasmuch as the incuba- 



