Smallpox: Why all the Fuss?
Michael Nightingale

Until the advent of the last decade smallpox has been an ever-present threat to public health for most of recorded history; yet no one can say for certain when or where the disease started. We know, of course, now that one of the causal factors is the variola virus which seems to exist in two distinct but indistinguishable forms producing on the one hand a disease known as variola minor which is often less serious than chickenpox, and on the other hand variola major which can vary from being comparatively mild to being so severe as to result in disfigurement or even death. In common parlance, all these conditions are known as smallpox.

It is a matter of pure speculation as to when the condition first appeared, but it is unlikely to have done so prior to man's establishment of large townships coupled with poor nutrition, overcrowding, lack of sanitation and inadequate hygiene. Keeping people, such as slaves and prisoners, in disgusting and sub-human conditions may have been the necessary ingredient for the establishment of the virus but there is virtually no doubt that the aforementioned adverse conditions were responsible for the epidemics of smallpox as well as for its endemic nature in certain areas until its recent demise. It was recorded in ancient Chinese history and was certainly prevalent in the west by the sixteenth century. It was introduced to America at the time of the Spanish Conquest and inexperienced Indians were decimated by the disease, tribes being reduced from many thousands to a few hundred.

When bad social conditions, particularly overcrowding, were prevalent the disease was greatly feared and people were always anxious to be exposed to mild cases in order that they might contract the mild form and be protected from the possibility of more serious illness in the future. Mothers exposed their babies to smallpox in the hope that if they acquired the disease when so young it would be mild. Variolation, or the practice of deliberately introducing the infectious matter from a smallpox patient to a healthy person became very popular. Sometimes this was done by placing the dried crusts from smallpox scabs into the nostrils of healthy persons; sometimes the smallpox matter was introduced under the skin. Naturally, it was taken from mild cases and this had the effect of sometimes spreading the milder variety of the disease; yet conveying some immunity to the more serious form. In 1754 the practice was described by the Royal College of Physicians as highly salutary to the human race. Ironically, it was declared illegal in 1840 in favour of the more spurious, but allegedly less dangerous, practice of vaccination.

At the other end of the time scale, the last recorded case of naturally occurring smallpox was in Somalia in October 1977; although two laboratory-induced cases developed in Birmingham in 1978. By December 1979 the Global Commission for the Certification of Smallpox Eradication had declared the world to be free from the disease, a declaration which was formally ratified by the 33rd World Health Assembly on 8th May 1980. This was an undoubted achievement which prompts considerable praise and invites the question as to how it was accomplished. To reply that it was due to vaccination is not merely facile, but an obvious mistake as a brief review of the situation will indicate.

Smallpox vaccination was introduced in 1798 by a certain Edward Jenner, who was thought to have obtained the material from cows suffering from pox. However he himself admitted later that it was from an infection of horses known as the 'Grease'. Often this became transferred to the udders of cows which were sometimes secondarily infected with syphilis. In fact, the Grease was cowpox of the horse and neither disease related to smallpox. Its proper name is eczema pustulosum -a loathsome disease producing profuse and often irritating pustules all over the body. Dr. Creighton and Prof. Crookshank, both renowned epidemiologists, showed 'that cowpox was a disease related to syphilis (2). No one knows exactly what the vaccine virus is (3) and as late as 1932 it was stated in the Lancet (4) that no practitioner knows whether the lymph be employs is derived from smallpox, rabbit-pox, ass-pox or mule-pox. It is fairly certain that at varying times and in different places the true variola virus was introduced into the vaccine so that although the vaccine virus was a variable and unidentifiable hybrid it was eventually related to the smallpox virus and as such may have produced some variable immunity of short duration as well as being technically illegal! One scientific investigator claimed to have examined some 2,000 vaccines and found them all to be different!

The literature abounds with examples of the failure of vaccination. After some twenty years of compulsory vaccination in this country the largest recorded epidemic of smallpox swept the land and the fatality rate was higher than in any previous epidemic. Some 40,000 people died from smallpox during that epidemic and most of these had been vaccinated. It is difficult to state exactly what the vaccination rate was 'since this varied from place to place, but generally speaking some 95% of smallpox cases had been vaccinated. In Mold (Flintshire) all the children born and living there had been satisfactorily vaccinated from 1853 to 1871; yet in the epidemic of 1871-2 there were 50 deaths from smallpox (5). One of the most useful studies on vaccination and smallpox was the one conducted in a military hospital in the Middle East in 1944 (6). One hundred consecutive cases of smallpox were studied and 96% of these were found to have been vaccinated. 70% had been vaccinated within two years. Fourteen of these cases died and of these only one had not been vaccinated. From this study it can be concluded with absolute certainty that vaccination failed to prevent small-pox and failed to prevent death from smallpox. We cannot conclude from this that it never protects against smallpox but the evidence in this particular example indicates that such protection, if it exists at all, is so minimal as to be worthless. One of the more interesting aspects of this investigation is that it takes successive cases from an heterogenous group and entirely rules out the oft quoted safety valve of pro-vaccinists that a particular 'batch' of vaccine was lacking in potency.

Period Deaths per million per year from smallpox % of vaccinations/live births.
1838-42 576 60
1847-50 292 70
1851-60 221 80
1861-70 149 85
1871-80 228 85.6
1881-90 45 83.3
1891-1900 14 68.5
1901-10 13 69.6
1911-20 0.4 44.1
1921-30 0.6 43

Table I Annual mortality from smallpox in England & Wales from 1838-1930 and corresponding infant vaccination take-up rate.(8)

Period Town Population    Crude Smallpox deaths Mortality from smallpox per 100,000 population
1871-2a 100,000   358 358
1892-3b 183,000 21 11
1902-3 220,000 21 9
1903-4 224,000 4 2

  Table 2 Showing mortality from Smallpox in Leicester from (a) 1871-2 during maximum vaccination period and (b) epidemic years from 1892-1904 during minimum-vaccination years.(9)

Space does not permit a more detailed study of the effect of vaccination upon communities except to re-iterate the sad truths that:

I. Highly vaccinated communitites had high smallpox rates and high death rates from the disease (7,8) cfTable I & Fig I.

2. Unvaccinated or relatively unvaccinated communities suffered low rates of smallpox and low rates of mortality (e.g. Leicester) cf Table 2.

3. Routine smallpox vaccination left a constant trail of devastation and death in the form of post-vaccinal encephalitis, generalised vaccinia and other complications. cfTable 3.

4. Apart from the recognisable and well accepted complications from vaccination, there is considerable evidence that the procedure introduced the elements of disease into the system and that it is impossible to tell how long it may remain in the body undetected or in what way it may be ultimately manifested. Studies as recently conducted as 1970 have indicated that serious, degenerative diseases such as multiple sclerosis may be provoked by vaccination (10). In 1926 Prof. Mcintosh said that:

"Scientifically it cannot be disputed that from every point of view the injection of a virus capable of multiplying in the body is bad. Among the ill effects, apart from the more serious ones, are: erysipelas, boils, impetigo, pemphigus. tetanus, psoriasis, pyemia and nervous diseases".

At the turn of the century conditions improved and zymotic diseases began to ameliorate. cf Figs I & II. Smallpox was no exception so that despite vaccination (which had now become unpopular and far less prevalent) the disease slowly disappeared. During most of the twentieth century epidemics of smallpox in the UK have been started by vaccinated travellers returning from endemic areas. Despite the low acceptance of vaccination and dire warnings from pro-vaccinists, epidemics were increasingly well-controlled and it seemed by the mid-century that smallpox 'vas virtually a non-existent disease in this country.

It is extremely probable that the modern varieties of smallpox vaccine did give some protection for a short duration of time. The official protective life of smallpox vaccination is quoted at three years when there is no smallpox about and one year at the most when there is an epidemic! This, of course, makes sheer nonsense of Jenner's claim of lifelong protection (for which he fraudulently obtained large sums of money from the British Government) and explains why so much routine vaccination was both useless and dangerous. It also supports the view that vaccination of contacts might be helpful in controlling an epidemic. Much more important, however, are proper housing, isolation of cases, surveillance of contacts and other sensible public health measures which were adopted in recent times. The role of vaccination could not have been more than minimal and it is doubtful if, on balance, it would have made any difference whatsoever to the ultimate victory over smallpox. Not only did routine smallpox vaccination have no apparent influence on the incidence of smallpox anywhere, it even impeded the decline of the disease from general health improvement.

It may be asked why, if vaccination was so manifestly unhelpful. it was propagated with such enthusiasm? Again, space scarcely allows an answer except to say that the influence of money and prestige had a considerable part to play. Dr. Killick Millard. a vaccinist, said, "I venture to suggest, with all respect, that very few medical men are able to approach this subject with unbiased minds. From the earliest and most susceptible years of their medical careers bias is instilled into them by their professional pastors and masters." (13) The great Dr. Creighton, a vaccinist until he was asked to write an article on the subject for the Encyclopaedia Britannica upon deeper investigation into vaccination came to the conclusion that it was a "grotesque superstition". For this view he was "dropped into oblivion" by the profession despite the fact that he was described as the greatest medical brain of his time.

Entire textbooks have been devoted to exposing the dangers and ineffectiveness of smallpox vaccination when used as a routine measure. As far as the ill-effects are concerned, Conybeare reported 222 cases of post-vaccinal encephalomyelitis, of which 110 were fatal, in twenty years from 1927-46 (14)". Table I gives a summary of complications from vaccination in the UK from 1951-1970 and it will be seen from this that postvaccinal encephalitis forms but a minor pro-portion of all the reported ill-effects from vaccination. Most of these other complications could probably have been avoided if medical officers had noted the literature in which it has been clearly shown that certain categories of people should not be vaccinated. It cannot be described by any word less than horrific how these criteria were ignored for so many years which resulted in so much serious ill-health for no possible advantage.

TABLE 3 (15) Complications from smallpox vaccination from 1951-1970.

Post vaccinal encephalitis 40
Eczema vaccinatum 27
Yaccinia gangrenosa 13
Benign generalised vaccinia 2
Others 19
Total 101

Prof. Dick (15) reports 147 cases of post-vaccinal encephalitis in England and Wales from 1951-1970 of which 36 were fatal. Under-reporting of complications from all forms of vaccination is well known.(16) During the year 1963 alone there were 398 requests made to the Red Cross for hyperimmune gammaglobulin in the US; yet one vaccinator clearly stated that he never saw any ill-effects from vaccination! Obviously his vaccinated victims must have gone elsewhere to report their complications. Triau et al report 3,000 complications from questionnaires sent to doctors in that particular year with 18 deaths.(17) They estimate 200-300 deaths from vaccination in the US in under twenty years from 1948 – an annual toll of at least ten deaths. A gruesome reminder of the penalty exacted for the worship of a dogma.

The incontrovertible fact is that smallpox declined with declining vaccination rates, not only in the UK but throughout the world. (cf Figs I and II) From 1919-1927 there were 0.46 deaths per million from smallpox in England & Wales where vaccination had declined considerably. The corresponding rates 'for Czechoslovakia, Roumania, Spain, Italy and Portugal, all of which had universal vaccination and re-vaccination were:

10.3, 23.4, 47.4, 65.7,101.1, and 386! Mortality from smallpox in vaccinated Spain was more than 80,000% higher than in relatively unvaccinated England & Wales. Smallpox was virtually unknown in unvaccinated Australia and the disease was eradicated from Mali and Sierra Leone, where they previously had the highest smallpox rates in the world, with only 51 and 66% vaccination rates. We may also deduce from Figs I and II that if vaccination reduced mortality from smallpox then non-vaccination did the same for other diseases.

Much of the mortality from smallpox in earlier years was undoubtedly due to the way in which the disease was treated, as it was to malnutrition. Patients were placed in sick rooms in which bed curtains were tightly drawn and blankets nailed over the windows. The patients breathed foul air and remained day and night in foul bed linen. Sometimes, they were even given second hand smallpox garments to wear. Small wonder that they died! This stands in stark contrast to statements from experienced physicians such as Dr. Sydenham, who said, "It is most clear to me that if no mischief is done by either physician or nurse, it (smallpox) is the most slight and safe of all diseases". Sir Robert Rawlinson said, "I have seen smallpox patients exposed in an English summer place under open sheds and in barns, sleeping on straw and fed by cottagers with food of the simplest character, the result being that not one patient so treated died neither did the disease spread, but many deaths took place among the afflicted who remained in their houses".(18).

Why bring all this up again since most of it has been well aired in the past - particularly now that routine smallpox vaccination in the UK has been discontinued for more than a decade and the world has now been declared to be free of smallpox? There are three reasons for doing so:

I. Because a few countries are still insisting on vaccination for entry despite frequent requests on the part of the World Health Organisation not to do so. These demands are quite illogical, unwarranted and immoral. As recently as June 1981 the British Medical Journal declared that the demands of Chad and Democratic Kampuchea in this direction were "unnecessary and unethical". "All travellers should be advised against smallpox vaccination and if necessary provided with waiver letters signed by the doctor.(19)

2. Vaccination could be even more dangerous to the community now that routine procedures have ceased. The population at large has little or no experience of the vaccine virus and this could become increasingly more infectious and dangerous. It is therefore not merely the foolish individual who submits to vaccination who is at risk but innocent contacts who may pick up the virus.

3. Whilst we do not argue that all vaccinations for other diseases are ill-advised, much of the arguments presented concerning smallpox vaccination may be applied to other vaccines from time to time. It is therefore useful to have on record the obstinate and crass stupidity of those who have gone on vaccinating and advocating vaccination long after any vestige of justification could be found for it and at a time when most of its erstwhile proponents had changed their minds as to its advisability.


Vaccination for smallpox was fraudulently inaugurated and dishonestly maintained to the financial and health cost to the public which is beyond estimation. It did little or nothing to eradicate smallpox in endemic areas, has been directly responsible for thousands of deaths since its inception in the UK alone, and has sown the seeds of disease throughout the world. In the recent control of imported smallpox isolation and surveillance have proved to have been effective methods, and selective vaccination of contacts has played a minor part at the best. The use of modern vaccines may have been helpful in these cases but the long drawn-out routine vaccination cannot be retrospectively justified, and the present day intransigence of a few governments and travel agents who insist on vaccination for a non-existent disease can scarcely be described as less than criminal. Ill-effects from vaccination have been consistently under-reported and minimised in a way that appears to consider the general population more like a herd of ignorant domestic animals than responsible people.

It is terrifying to realise that it took more than twenty years of deaths from vaccination far outnumbering deaths from smallpox finally to convince the DHSS to alter its recommendations regarding smallpox vaccination in 1972: a year later than the United States Public Health Services in that country and long before corresponding health authorities in most of Europe. The great question that seems to stand out amidst all this is, "Should parents entrust their children's health and future to a Ministry or Government Department?" Clearly, anyone who does this places himself or his child at risk. In these days of readily available information and general education it should be quite possible for people to make up their own minds without being "directed" by a Ministry or by those who are its agents.


1 Swan, J. P., The Vaccination Problem, 1936, C. W. Daniel,p 171.
3. Bedson K. H., & Dumbell K. R., Vaccine Hybrids, The Journal of Hygiene, 1964,62, 147.
4. Lancet, 1922, 1, 958
5. Dr. Seaton to the Select Committee of the House of Commons.
6. Illingworth R. S., & Oliver, WA., Lancet 1944,2,681.
7. Dixon, C. W., Smallpox, 1962, J. & A. Churchill, London, p.1
8. Swan,J.P.,op cit p 120.
9. ibidp157.
10. Brit Med.J., 1970,3,272.
11. Prof. I. Mcintosh, in Presidential Address to the Royal Society of Medicine, 19th October, 1926.
12. Millard, C. K., The Vaccination Question in the Light of Modern Experience, H. K. Lewis, London, 1914, pp. 16 & 17.
13. Hospital & Health Review Dec.1921.
14. Conybeare E. T., Monthly Bulletin Min Health 1948, 7,72-79.
15. Dick, G., Immunisation, Update 1978, p. 52.
16. Wilson, Sir Graham, The Hazards of Immunisation, Athlone Press, London, 1967, p.5
17. Triau, R.. Tanzy G., & Tanzy F.,Medicine & Hygiene, 1966,756, 1177-79.
18.The Times, 14th June, 1888.
19.Brit Med.J., 1981,2,1880.

Source: Epoch magazine Vol 4 No 1 1981.

[Vaccination]  [Smallpox]