We do not know how long this second attempt at village relay lasted and how the program fared in later years. Records on it end with the final, ninth volume of Kasahara Ryōsaku's "Vaccine Travel Record." There is a strong possibility that the village relay method was not continued, most likely because of a lack of funding from the domain. Despite Kasahara’s efforts at cost-cutting, village relay required a massive investment of money and personnel. The five visits to Gamō, for example, cost 1,293 monme of silver, only 612 monme of which were covered by donations. To make up for the difference, Kasahara and district governor Okada both contributed some of their own money and had some of the loss reimbursed by the district office. Without regular funding from the domain, the expeditions would have been unsustainable.

When the district governor reassessed the financial situation after the first visit to the coast, it turned out that only 60 out of 211 recipients of vaccinations in Gamō had donated the suggested amount of 10 monme of silver. The governor believed that in order to continue, he needed to put more pressure on potential donors. When the vaccination clinic thus sent out its next call for villages to apply, the text no longer explicitly mentioned the possibility of poor parents being exempted from donations.

Donation rates were much higher during the second tour to Koniu, probably because the district office had applied more pressure on villagers. But Kasahara was taken aback by the district officials’ strictness. He had been notified of a rumor that he was enriching himself by collecting 10 to 20 monme per vaccination, and he did not want to add any more fodder to such talk that could have endangered the success of the program. At the bottom of the rumors about profiteering lay an unresolved question. Rural vaccinations required organizational capacities and pressure of the kind that only a government could provide, yet the domain government was not able or willing to fully fund the program, causing confusion among subjects about its public character. A much larger investment in public health was necessary to obtain the doctors, transportation, and bureaucracy needed to immunize every child in the domain.

However, there are indications that the clinic in Fukui later transmitted the vaccine to rural physicians. The very last entry in the "Vaccine Travel Record" notes a letter from 1860 by Fujii Shinsai, a physician trained in surgical medicine in the coastal village of Umeura, in which he asked Kasahara for a transmission [Hakushinki, p. 247-48; Fukui Ishikaishi, p. 632]. This might have been an acceptable solution in Kasahara's eyes if, like Fujii, they received official permission to handle vaccinations.

But not all rural physicians bothered to obtain such permission. Go to the pathway Vaccinating the Nishikata Exclave to learn more about a case of illegitimate transmission. Or stay on this pathway to learn about an alternative to village relay.