ILLINOIS STATE BOARD OF HEALTH-No. 60 
OFFICIAL CIRCULAR 
Concerning the Vaccination of SchoohChildren. 
OFFICE OF THE SECRETARY. 
Springfield, III,, March, 1882. 
At the annual meeting of the State Board of Health, held in Chi- 
cago, March 2-3, 1882, (adjourned from Springfield, January 19,) the 
subject of the Vaccination of Public School-Children being under 
consideration, the Secretary called attention to the suggestion in his 
informal report (previously submitted,) as to the propriety of the 
Board considering whether any modification of the School-Vaccination 
Order was necessary or expedient, and if so, in what respect. He 
stated that while the Order had been very generally complied with, 
and the results obtained had fully justified the wisdom and timeliness 
of this action of the Board, there were certain facts and conditions 
which seemed worthy of attention. 
These are briefly as follows: 
1. The winter has been an unusually open one, and in many por- 
tions of the State the country roads have been, and still are, almost 
impassable, while the high water in many localities adds to the diffi- 
culty. All this causes much labor and expense, both to vaccinating 
physicians and to parents, which will be avoided as the roads dry up 
and the weather becomes settled. 2 
2. The unusual demand for virus has made it impossible to procure 
a supply in many localities. 
3. There is among many a bias for vaccinating in April, May or 
June,—a preference which may very properly be deferred to. From 
the climatic conditions of this State the months named are certainly 
more favorable than the winter and early spring. There is then less 
risk of complications from sudden changes of temperature and other 
causes. 
4. The measure has been a very radical and sweeping one. Some 
time must be allowed for education in such cases. Prejudices and op- 
position,—which, of course, the Board may, and which it would be its 
duty in an emergency to, disregard,—will largely disappear if time be 
granted for reflection, discussion and information. 
5. The immediate sanitary necessity which dictated the enactment 
of the Order in November last does not now exist. The disease is 
declining in the State at large. 
In view of all these considerations, the question presents itself: 
Will it not be wise and profitable to suspend the enforcement of pen- 
alties for non-compliance until such time as the vast mass of data 
now being accumulated can be digested, an accurate view of the results 
already obtained be had, and the best course determined upon to make 
the Order permanent and fully operative with the least friction and 
hardship. 
At the conclusion of the Secretary’s remarks, the Board— 
Ordered, That the Secretary be authorized to take such steps in 
his judgment, may be necessary to secure the completion of the work 
of a full protection of the school children of the State aghinst small- 
pox ; which disease still exists to some extent, and is liable again to be- 
come prevalent so long as the enormous immigration continues, and 
while any considerable number of persons remain unprotected in 
any community. \ 
In pursuance of the above authorization it is desired to learn from 
school authorities,—County Superintendents, School Directors and 
Teachers,—their views as to the most feasible plan by which to secure 
a completion of the work. Suggestions as to extension of time, with 
reasons therefor; details of difficulties encountered; and any other in- 
formation, based upon experience, will be cordially received. 3 
It should be understood that it is the fixed intention of the State 
Board to extend this absolutely necessary measure of protection 
against a loathsome disease to every scholar in attendance at the pub- 
lic schools of this State,—not simply to meet this emergency but to be 
prepared against the possibility of a future epidemic. 
In Chicago, for the past fourteen years, one of the first questions 
asked of an applicant for admission to school is : Where is your vacci- 
nation certificate ? Until this is produced, the child can not enter the 
school as a pupil. Result: During the present epidemic it is stated 
that there have been six thousand cases of small-pox and varioloid in 
that city. This is in the proportion of one case to every one hundred 
inhabitants. In the same ratio the number of cases among the school 
children would be between five hundred-and-fifty and six hundred. 
The actual number of cases has been just seven. And, notwithstand- 
ing the existence of such a wide-spread epidemic, not a single school 
has been closed, nor a child (except the seven mentioned) been 
deprived of school facilities in that city. 
What has been done in Chicago can be done in the State at large; 
and it is the purpose and duty of the State Board to spare no effort to 
this end. 
Now that there is a lull in the present epidemic, the work may be pro- 
ceeded with more deliberately and with more thoroughness. But it will 
not do to defer action too long. It is a poor time to vaccinate in the face 
of an epidemic. Doctors are then too busy; vaccine is scarce and high- 
priced ; and, more importantly than all else, the results of vaccination 
are generally much more severe, and complications more frequent, 
during the prevalence of small-pox. To defer vaccination until small- 
pox appears is about as wise as to wait until a conflagration is raging- 
before organizing the fire department and providing the water-supply. 
And it should not be forgotten that this conflagration is only smoulder- 
ing in many localities. The disease may yet spring up into epidemic 
proportions in many parts of the State before it is entirely suppressed. 
It is tolerably sure to do so wherever there are many unprotected 
individuals. Already, since the adjournment of the Board, there have 
been reported more new infected points in three days than in the three 
weeks previous. These new infection-centres are confined to the 4 
southern portion of the State, and to counties where the enforcement 
of the Vaccination Order by the school authorities has been the most 
delayed or neglected. As a result, in at least two townships, the schools 
have been broken up,—a disaster which would have been avoided had 
the Order been complied with. 
For the present, however, and until the promulgation of further 
orders, the exclusion of children not yet vaccinated need not be 
insisted upon, except in localities where small-pox now exists, 
or where it may hereafter occur. In such localities the provisions of 
the Vaccination Order (S. B. H. No. 50B,) must be rigidly enforced. 
No child not properly protected against small-pox, as such protec- 
tion is defined in said Order, must be allowed to attend a public school 
in any place where there is small-pox. It is the duty of the local 
health authorities, as well as of the school directors, to exclude all 
such unprotected children. 
As previously stated, there is no necessity for closing a school in the 
presence of small-pox if this measure be faithfully enforced. 
By authority of the Board : 
JOHN H. BAUCH, M. D., Secretary. 
Note.—County Superintendents are respectfully requested to secure 
the publication of this Circular (or its purport) in the local press, so 
as to insure a prompt and general knowledge of the purposes of the 
Board. A pro rata supply is sent to each County Superintendent for 
distribution; but additional copies will be furnished, or will be mailed 
direct to school directors, teachers and others, on receipt of addresses. 
J. H. B.