RESULTS OF PROPHYLACTIC VACCINATION AGAINST PNEUMONIA AT CAMP WHEELER.

1. 13,460 men, or about 80 per cent of the entire camp strength, were vaccinated against pneumonia with pneumococcus lipovaccine. 2. The dosage employed in all cases was 1 cc. of the lipovaccine containing approximately 10 billion each of Pneumococcus Types I, II, and III. 3. Both the local and general reactions produced by the vaccine were usually mild. Only 0.7 per cent of those who received the vaccine were sufficiently affected to need hospital care. None of these was seriously ill, and a majority of them returned to duty on the 2nd or 3rd day after admission. 4. Most of the troops inoculated were under observation for 2 or 3 months after vaccination. During this period there were 32 cases of Pneumococcus Type I, II, and III pneumonia among the vaccinated four-fifths of camp, and 42 cases of pneumonia of these types among the unvaccinated one-fifth of camp. If, however, all cases of pneumonia that developed within 1 week after vaccination are excluded from the vaccinated group, there remain only 8 cases of pneumonia produced by fixed types, and these were all secondary to severe attacks of influenza. This exclusion is justified by the fact that protective bodies do not begin to appear in the serum until the 8th day after injection of pneumococcus lipovaccine. 5. There is no evidence whatever that pneumococcus vaccine predisposes the individual even temporarily toward either pneumococcus or streptococcus pneumonia. 6. The weekly incidence rate for pneumonia (all types) among the vaccinated troops was conspicuously lower than that for the unvaccinated troops. 7. The pneumonia incidence rate per 1,000 men during the period of the experiment was twice as high for unvaccinated recruits as for vaccinated recruits, and nearly seven times as high for unvaccinated seasoned men as for vaccinated seasoned men. 8. Influenza causes a marked reduction in resistance to pneumonia even among vaccinated men. Of the 155 cases of pneumonia (all types) developing 1 week or more after vaccination, 133 were secondary to influenza. 9. The death rate for 155 cases of pneumonia (all types) that developed among vaccinated men 1 week or more after vaccination was only 12.2 per cent, whereas the death rate for 327 cases of all types that occurred among unvaccinated troops was 22.3 per cent. The death rate for primary pneumonia among vaccinated troops was 11.9 per cent. Among unvaccinated, it was 31.8 per cent, almost three times as great. On the other hand, the mortality rate in pneumonia secondary to influenza is about the same for the vaccinated and unvaccinated groups. 10. In conclusion, it must be admitted that the results of pneurnococcus vaccination at Camp Wheeler have not been so striking as those obtained at Camp Upton in 1918, largely on account of the influenza epidemic; but, although influenza obscured to some extent the effect of pneumococcus vaccination at Camp Wheeler, the results are sufficiently encouraging to justify its further application in civil as well as in military life.