The mobilization of children for vaccinations continued to require a degree of persuasion and coercion. This was true even after the smallpox epidemic of 1852/53, which had increased the popularity of vaccinations. Upon Kasahara Hakuō's urging, the town governor of Fukui ordered each town section to keep twelve unvaccinated children at hand for times of storm, fire, mid-summer and mid-winter as well as year’s end to help vaccinators “connect” the vaccine when public interest was low. Physicians regularly surveyed the clinic's records to identify children who had failed to show up for their second appointment. At the clinic, guards prevented anyone without an exit pass from leaving the building to make sure that children designated as "pox bases" would not go home before they had accomplished their purpose. Money poor children  could not run on popularity alone; it required organization. [Umihara, Ban]

A floor plan of the new clinic in Shimo-Edomachi was recently discovered among materials of a domain doctor from Hikone domain [Umihara]. When read in combination with a manual on vaccination procedures (“Koshi no mae shū jotōkan tetsuzukisho”) from the same archive, this plan reveals that the rooms in the clinic were laid out to support the chronological sequence of treatments. The vaccinators also kept meticulous records on every child to convey information to teams of vaccinators operating on different days. Anxious to avoid mistakes that could damage the vaccine’s fragile reputation, they inscribed the biological rhythm of the vaccine both into their books and into the floor plan of their clinic.

Incoming children were all registered upon arrival and divided into three groups: those to be vaccinated; those vaccinated seven days ago who could serve as "pox bases"; and those vaccinated ten or more days ago, who reappeared for examination and possibly revaccination. Each child was first sent to the general waiting room (the so-called sō-dame), but was then classified by group and sent along a different sequence of rooms. The first group, for example, received a yellow sash and went to the upper examination room marked by a yellow flag. The second group received a red sash and was sent to the middle room, whereas the third group went to the lower examination room. After vaccination, parents received a paper ticket indicating the date of their child's follow-up visit, as well as an instruction sheet for aftercare at home [Umihara, Yanagisawa].

This page draws on research by Umihara Ryō and Yanagisawa Fumiko.