From Faroes Measles article by Dr Panum, 1846.
On the vaccination issue wrt the Faroes measles epidemic (and noting there was no measles vaccine for around 120 years afterwards!)
At present it might be hoped that such a calamity could be at least partially prevented by vaccination. It is obvious, however, that the physical character of the country renders it peculiarly difficult to carry this out satisfactorily. It could scarcely be done in any other way than for the physician to divide the islands into perhaps five districts, and to look after the vaccination in one of these each year, by turns, by making a double tour, so that he would manage to reach each village twice, with eight days’ interim, the first time to perform the vaccination, the second to learn the results. But it would he unreasonable to require such an inconvenience of the appointed physician without a corresponding remuneration, since, apart from other hardships, by such a long absence from Thorshavn as would be involved, he would lose a part of the income from practice to which the medical practitioner would be entitled.
This much, at least, is clear; that vaccination such as is now performed on the Faroe Islands is entirely unreliable and futile. The fact is that a rustic is delegated to travel around the country to vaccinate the children; for this purpose, he is provided with vaccine and a needle or lancet, and is instructed how to go about the operation. This rustic then engages in each village a man, who can write, to inspect the children eight days after vaccination and to write to the provincial surgeon as to whether or not the vaccine has taken. However, since on the one hand, it is quite doubtful, in fact in many cases even improbable, that the man who is to inspect the children has ever seen a characteristic vaccine pustule, and, on the other hand, since there is a question as to whether to serve his neighbor or countryman he is not capable of telling a slight falsehood, seeing that the inhabitants are often loath to have their children vaccinated, because they fear the grafting in of foreign diseases, and so on, it may easily be perceived what is to he expected of such control.
If, then, a complete reform is to be effected on the Faroe Islands in regard to vaccination, as is certainly most desirable, especially if freer conditions of trade are to be expected, it will not only have to be undertaken by the physician himself, in double trips, as suggested above, but it must also be carried out for all persons without exception, so that certificates of vaccination hitherto issued should excuse none from this slight operation. Scarlatina (Scarlett Fever, I assume) has never, as far as I know, visited the Faroes, nor, probably, whooping cough, though the latter is recorded in 1838 in some of the church registers as a cause of death; For this information seems to have originated only from the fact that during the prevailing influenza epidemic, one or another priest mistook a violent catarrhal chest infection for whooping cough. Measles had not prevailed on the Faroes since 1781 then it broke out early in April 1846.
And, as I noted on “The Informed Parent” Facebook site:
Chris Hemmings OK, I’m going to be bogged down in the treasure trove that is the Faroes report, above, for some time! Initially, though, one has to observe that the population was in a very unhealthy state, chronically so. [As is very well documented in the Panum paper] Thus infections, when they arrived, knocked many out quickly. Same reason as measles still finishes off so many kids to this very day – in very poor, malnourished, clean water scarce, third world populations. Note, also, that even in such populations, the measles infection tends to only kill the very young – the final straw!
Why did the population stay in an unwell but soldiering on state for so long? I’d argue that they had plenty of local bacterial types with which there was conversation and to which the population as a whole was accustomed. What you could, indeed, call “herd immunity” if you had a wish to!
However, as there was no population based measles “colony”, there was no current familiarity with its characteristics.
Now, in a well fed, housed and engaged population, the reintroduction of such bacteriotypes should cause little duress – we all have, naturally, a fast response mechanism, a detection, neutralisation and elimination system. In a chronically poor, malnourished, ill-housed and stressed population such responses are, understandably, severely compromised.
Hence the epidemic.