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JAMA Revisited
June 9, 2020

Immunization Against Plague: An Argument for Controlled Experiment

JAMA. 2020;323(22):2347. doi:10.1001/jama.2019.13488

Originally Published June 19, 1920 | JAMA. 1920;74(25):1719- 1720.

The reiterated plea of scientists for accurately controlled experiments in the determination of the value of measures adopted against disease may seem to some physicians to be somewhat too emphatic. Again and again, however, the disinterested scientist is compelled to protest against the use of statistics and experiments by those commercially interested and by overenthusiastic advocates of the prophylactic use of certain products. How difficult it really is to arrive at definite conclusions relative to the efficacy of many such preventive measures is pointed out by Flu,1 in a recent discussion of experiments on immunization against plague. The reports concerning the results of vaccination against this disease have been contradictory. Haffkine believed that he had demonstrated statistically that his vaccine was effectual in creating immunity. Bitter and other observers, analyzing the work of Haffkine, concluded that the immunity acquired was not of high degree and that it did not last more than six months. That opinions based on statistics may not be reliable, Flu illustrates by the recital of an incident occurring in the Division of Malang in Java:

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