JAMA 100 Years Ago Section Editor: Jennifer
Reiling, Assistant Editor.
In a recent issue of the Lancet,2 Dr.
J. Cooke Hibbert claims that vaccination or re-vaccination may be successfully
performed during the eruptive stage of smallpox, and cites eleven cases in
support of his contention, the vaccination in these cases having been performed
on the first, third and thirteenth day. This is by no means an uncommon occurrence,
as has been demonstrated frequently at the Chicago Isolation Hospital. Patients
vaccinated on the second and third day of the eruption, or up to the eighth
day, will, as a rule, have a typical take, but not after this time. In a paper
by Dr. Heman Spalding,3 published in THE JOURNAL several years ago, reference is made to an experimental vaccination
of over one hundred smallpox patients after the eighth day of the eruption.
In none of these cases was there a take. The case reported by Hibbert in which
vaccination was successful on the thirteenth day is probably one of a spurious
type, although it might have been a perfect vaccination. These findings only
prove that the tissues are not impregnated with the immunizing substances
of smallpox. The fact that vaccination or re-vaccination was successful in
a case having a rash of doubtful character is not an argument against that
case being one of smallpox, but in such a case a positive diagnosis will have
been made before there is any evidence of the outcome of the attempt at vaccination.
Hence, vaccination for diagnostic purposes during the eruptive stage of any
exanthem is of no value whatever.
VACCINATION DURING ERUPTIVE STAGE OF SMALLPOX.. JAMA. 2005;294(8):974. doi:10.1001/jama.294.8.974-b