A.—2.

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Enclosure in No. 83. Memorandum for the Assistance of Guardians and Others in framing and carrying out Arrangements for the Performance of Public Vaccination. [Vaccination Acts, 1867 aud 1871; Regulations of Ist December, 1859; and Regulations of 18th Eebruary, 1868.] 1. In order to secure the best sort of vaccination, the operation should, as far as practicable, be performed with fresh lymph direct from arm to arm. The lymph should be carefully selected from the best-formed vesicles upon the healthiest children, at the right period of the course of the vesicles. And the arrangements for public vaccination under the vaccination contracts ought to be framed so as to secure, as far as possible, these objects. 2. As, in ordinary circumstances, it is at tbe end of the week from vaccination that the arm of a child is in tlie state best fitted for yielding lymph, the attendances for the performance of public vaccination must be given at weekly intervals. 3. As, for keeping up vaccination in perfection it is essential that a public vaccinator should have on each vaccinating occasion a large choice of children and of vesicles, it is obvious that the cases for vaccination must not be divided between too many stations, or distributed over too many vaccinating days. 4. It is only in very populous districts that weekly vaccination can be maintained efficiently throughout the year. If au attempt were made to keep up vaccination throughout the year at a vaccination station to which, say, one hundred cases are brought annually, it would be found that, as the births are not equally spread over the whole year, and as accidental circumstances must often interfere with the bringing of children in particular weeks, there would not unfrequently be no cases at all at the station to supply lymph, and in the majority of weeks not a sufficient number of children to enable the vaccinator to make a proper selection. 5. Hence, in districts which are not very populous, it is necessary that public vaccination should be performed at certain periods of the year, as at quarterly or half-yearly periods, weekly attendances being then given for two, three, or four, or more successive weeks, according to the population for the accommodation of which tho particular station is designed. 6. Without attempting to lay down a precise rule on a question which must largely be decided according to the circumstances of each locality, it may be said, generally, that any station at which there are less than eighty vaccinations annually should not be attended more frequently than at half-yearly periods. 7. Provision is made by the 12th section of "The A raccination ilet, 1867/*" by which, in districts in which public vaccination is performed at intervals exceeding three months, parents of children attaining the age of three months do not become liable to penalty for the non-vaccina-tion of their children until after the next public vaccination held in the district subsequently to their having attained that age. 8. Children living within two miles of a vaccination station cannot (unless under special circumstances) legally be vaccinated by the public vaccinator except at the station, and at the time specified in the contract. If, however, some special reason require this rule to be departed from in any particular case, an entry stating the " special reason " must, in accordance with the Regulations of 18th Eebruary, 1868, be made in the vaccinator's register. 9. Having regard to weather and to other considerations, the months of April and October will generally be found most suitable for half-yearly vaccination. 10. In framing periodical arrangements for districts in which there are two or more stations, the attendances should not commence in the same week at all the stations, but a week or two should be given for establishing at the most frequented station a supply of lymph with which to start vaccination at the others. 11. It is convenient that, as far as.practicable, the stations of a district should be attended on the same week-day, in order that, when necessary, lymph may be taken fresh from station to station. 12. In districts in which public vaccination is fixed to take place periodically, the public vaccinator should, on the day week preceding the first day of the periodical attendances appointed under Schedule A to the contract, vaccinate with lymph stored by himself or obtained from the National Vaccine Establishment, or some other trustworthy source, two or three selected children, jirrangements should be made for bringing these children to the station on the day appointed for beginning the periodical vaccination of the district, and tho lymph from their arms will afford means of starting such vaccination satisfactorily. The public vaccinator, in registering these vaccinations, should, in accordance with Regulation 1 of 18th Eebruary, 1868, state in his register the special reason for their not having been vaccinated at the station. 13. By section 7 of "The Vaccination Act, 1867," it is provided that all vaccination stations (except at the residence or surgery of the public vaccinator) shall be provided by the Guardians. 14. Vaccination stations must be within the district for which they are to serve, and must not be fixed at union workhouses, as the independent poor are unwilling to resort for vaccination to an institution connected with pauper relief. The same objection applies, though perhaps in a minor degree, to the appointment of pauper pay stations as vaccination stations. The Board further consider it undesirable that public-houses should be selected, for the purpose. Whatever room or place be selected as a vaccination station, it is essential that the public vaccinator should have the exclusive use of it during the time of vaccination. 15. In large towns the vaccination station should, if possible, be at some public building— • e.g., town hall, meeting hall, or school, or at rooms specially hired for the purpose. Various