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October 20, 1923


JAMA. 1923;81(16):1374-1375. doi:10.1001/jama.1923.02650160048021

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The Defense of London Against Smallpox  The outbreak of smallpox in London, following the Gloucester epidemic, has brought into prominence a question that has for several years caused much concern. Are we, because of the neglect of vaccination, in danger of epidemics such as occur from time to time in unvaccinated populations? The prospect of an epidemic in London, the largest aggregation of people on the globe (amounting to seven millions), is appalling, even if only cost is considered. A case of smallpox costs the community directly $1,000. To this must be added, in the case of an epidemic, the widespread interference with business. The total loss would be a serious addition to financial burdens, which already are as great as we can bear. Neglect of vaccination has increased so much that between the years 1908 and 1918 the percentage of vaccinations to births fell from 63.2 to 41.5, and

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