From inoculation to vaccination: smallpox in Sweden in the eighteenth and nineteenth centuries.

Abstract

Smallpox was a dominating cause of death in eighteenth-century Sweden. Inoculation, introduced in 1756, was never widespread. The districts with the highest mortality at the end of the century were more prone to accept vaccination when it was introduced in 1801. However, within 15 years almost 80 per cent of all new-born children were vaccinated. The organization of vaccination was efficient, vaccinators were appointed in all 2,500 parishes in Sweden, and a report system gave all the necessary information. The last step was taken in 1816 when vaccination became compulsory. Before vaccination; 95 percent of smallpox deaths were those of children, but after 1801 it became as common among adults. Due to problems with re-vaccination, adults faced a much greater risk of infection during the last epidemic of 1873–75 than during the previous century. After the 1880s smallpox became an uncommon disease and smallpox deaths were rare.