Is there solid evidence to prove that the smallpox vaccine eradicates smallpox waves? A deep dive into the literature has resulted in surprising findings.

By Yuhong Dong

January 05, 2024

The widespread faith in vaccines is often traced back to the assumption that the first vaccine in human history effectively eradicated one of the deadliest pandemics. However, does this belief hold true?

Despite the unclear nature of the original smallpox vaccine invented by Dr. Jenner and its increasing failures and medical challenges, there remains an underlying societal belief that smallpox vaccines effectively prevent smallpox. By the year 1801, an estimated 100,000 people were vaccinated for smallpox in England.

In the 1970s, a smallpox global eradication effort led by a World Health Organization (WHO) officer and American medical doctor, Dr. Donald Ainslie Henderson (1928 to 2016), initially used a strategy of mass vaccination campaigns to achieve 80 percent vaccine coverage in each country.

The campaign integrated mass vaccination programs, surveillance of outbreaks, and rapid response to any reported cases. By 1977, the last natural case of smallpox was recorded in Somalia, leading to the WHO’s declaration of smallpox eradication in 1980.

Yet this begs the question: Is there any direct evidence that the infection or mortality rate has declined due to vaccination?

In search of evidence that smallpox vaccination plays a direct role in eradicating the smallpox waves, we found quite a few examples showing that the waves of smallpox seen throughout history were even more severe after a massive vaccination program.

US: No Decline After Vaccination

Dr. Suzanne Humphries, an internist and board-certified nephrologist has practiced medicine in conventional hospital settings for over 20 years. The graphs below represent some key facts from her book about smallpox, “Dissolving Illusions.”

She spent countless hours at Yale’s medical library and other libraries scouring medical journals, books, and newspapers to locate mortality data and create computerized graphs.

Records from Boston, starting in 1811, reveal recurring smallpox epidemics beginning around 1837. Despite the introduction of vaccination mandates in 1855, epidemics continued to occur in 1859 to 1860, 1864 to 1865, and 1867, with a particularly severe outbreak from 1872 to 1873. The continual recurrence of these epidemics in Massachusetts indicates that stringent vaccination regulations had no positive impact on curbing smallpox.

Smallpox vaccination and Boston smallpox mortality rates from 1811 to 1926.

According to the research article, “SmallPox and Revaccination,” published in the 1881 Boston Medical and Surgical Journal, “The latest epidemic that of 1872–1873, having proved fatal to 1,040 persons, was the most severe that has been experienced in Boston since the introduction of vaccination.”

In Chicago, despite 95 percent vaccination coverage by 1868 and mandatory vaccination after the Great Chicago Fire of 1871, a severe smallpox epidemic occurred in 1872. Over 2,000 people contracted smallpox, and more than a quarter of these died, with the highest fatality rate among children under age 5.

Europe: No Decline After Vaccination

Throughout the Western world, epidemics were more severe in highly-vaccinated populations.

Dr. G. W. Harman published an article in the 1900 medical journal Medical Brief entitled “A Physician’s Argument Against the Efficacy of Virus Inoculation,” highlighting widespread smallpox cases among vaccinated individuals in England, France, and Germany.


In England, the smallpox vaccination became compulsory in 1853.

Yet since then, there have been three smallpox epidemics. The first occurred from 1857 to 1859, with 14,244 death cases; the second happened from 1863 to 1865, with 20,059 deaths; the third wave, from 1870 to 1872, had 40,840 deaths. The population increased from the first to the second epidemic by 7 percent, yet the increase in smallpox cases was nearly 50 percent. The population increased by 10 percent from the second to the third epidemic, yet smallpox cases increased by 120 percent. 

Dr. Harman cited data published on July 15, 1871, from The London Lancet reporting that of the 9,392 smallpox patients in London hospitals, 6,854 had been vaccinated (73 percent) and 17.5 percent of vaccinated patients died.

In an 1881 outbreak in Bromley, England, all 43 victims were vaccinated and 16 cases were severe.

The death rate for smallpox declined after 1872, but there is no evidence that vaccination had anything to do with it. In the early 1900s, death from smallpox all but vanished from England.

Smallpox mortality rates for England and Wales from 1838 to 1922. (Dissolving Illusions, Suzanne Humphries)


During the Franco-Prussian War from July 1870 to January 1871, the French army had 23,469 smallpox cases and every army recruit was required to be vaccinated.

Dr. Charles Creighton’s 1888 critical review in the Encyclopedia Britannica highlighted a mortality rate from smallpox in Prussia of 60,000 deaths between 1870 and 1873, despite widespread vaccination. “Not withstanding the fact that Prussia was the best revaccinated country in Europe, its mortality from smallpox in the epidemic of 1871 was higher (59,839) than in any other northern state,” he wrote.


In Bavaria, Germany in 1871, nearly 96 percent of all smallpox cases occurred in vaccinated individuals (29,429 of 30,742).

Between 1870 and 1885, official records indicated that 1 million vaccinated individuals died from smallpox.


In 1888, despite a population in Italy that was extensively vaccinated and revaccinated, smallpox wreaked havoc in numerous towns. Many of these towns had adhered to a biannual vaccination regimen for several years.

New Yorkers queued up for their smallpox vaccinations in April 1947. (FPG/Hulton Archive/Getty Images)

In 1899, Dr. Ruata documented the failure of vaccination in Italy. Numerous smallpox outbreaks resulted in 18,110 deaths, including the following notable instances:

  • Badolato recorded 1,200 smallpox cases (population 3,800).
  • Guardavalle had 2,300 cases (population 3,500).
  • St. Caterina del Jonio had 1,200 cases (population 2,700).
  • Sortino documented 570 deaths (population 9,000).
  • San Cono had 135 deaths (population 1,600).
  • Vittoria reported a staggering 2,100 deaths (population 2,600).

Dr. Ruata wrote: “Can you cite anything worse before the invention of vaccination? And, the population of these villages is perfectly vaccinated, as I have proved already, not only, but I obtained from the local authorities a declaration that vaccination has been performed twice a year in the most satisfactory manner for many years past.”

Japan: No Decline After Vaccination

Dr. Simon Katzoff reported that compulsory vaccination laws began in Japan in 1872, and stricter revaccination mandates were passed in 1885. Laws required infants to be vaccinated and revaccinated up to three times within their first year if the first attempt was unsuccessful, then every year after that for seven years.

However, these measures didn’t prevent outbreaks. Smallpox remained rampant.

Between 1885 and 1892, with over 25 million vaccinations and revaccinations, there were still 156,175 smallpox cases and 39,979 deaths. From 1892 to 1897, Japan recorded 142,032 smallpox cases and 39,536 deaths.

Even after an 1896 law mandating vaccination every five years for everyone, the country saw 41,946 cases and 12,276 deaths in 1897 alone—a 32 percent mortality rate—almost double the rate before the vaccination era.

Smallpox epidemic with hospital ships transporting patients to Long Reach, 1884. 

Smallpox Waves Fluctuate, Independent of Vaccinations

Based on the smallpox waves noted above, the virus appears to independently fluctuate, regardless of vaccination.

For instance, in the 1700s, London witnessed a substantial decline in smallpox deaths, even before the widespread use of vaccination. In the 18th century, several outbreaks occurred, despite vaccination mandates.

From 1872 to 1909, despite the declining rate of smallpox vaccination in England and Wales from nearly 90 percent to only 40 percent, smallpox mortality remained low (near zero) after 1906.

It’s important to note that these changes occurred independent of vaccination efforts, suggesting that factors other than the vaccine played a significant role in declining smallpox rates.

Some researchers propose that either a decrease in the virulence of the smallpox virus, or the natural progression of the disease through susceptible populations, could explain the decline in cases independent of vaccination efforts.

Mandatory vaccination laws have proven to be ineffective in controlling smallpox outbreaks. This is similar to what we saw with COVID-19 during the past four years; new mutants would come and go, regardless of vaccination mandates.

Israel’s attempt to control the COVID-19 pandemic through mandatory massive vaccination beginning in December 2020 was a failure. In August 2021, Israel saw a dramatic surge with some of the highest daily infection rates in the world, despite its aggressive vaccination policy.

Israel’s mandatory vaccination program did not stop the COVID-19 pandemic. 

A 2021 study published in the European Journal of Epidemiology systematically analyzed the relationship between newly reported COVID-19 cases and the percentage of the population fully vaccinated across 68 countries and 2947 counties in the United States.

No clear link was found at the country level between the fully vaccinated percentage of the population and the number of new COVID-19 cases reported. Interestingly, the trend even hints at a slight increase in COVID-19 cases per million people in countries with a higher vaccination rate. For example, Israel, despite more than 60 percent of its population being fully vaccinated, recorded the highest number of COVID-19 cases per million people in the last week.

In the 2947 counties in the United States, there was no sign of decreased COVID-19 cases associated with higher vaccination rates.

Despite the assertion of the short-term effectiveness of vaccines in reducing the risk of serious illness and death, the U.S. Centers for Disease Control and Prevention (CDC) observed an increase in hospitalization and death rates among fully vaccinated people. For example, from January to May 2021, hospitalization and death rates in this group rose from 0.01 percent to 9 percent and from zero to 15.1 percent, respectively.

Smallpox Vaccination Mandates in the 1900s

The more severe variola major form of smallpox was prevalent in the United States during the 19th century, with two significant outbreaks between 1900 and 1925. Meanwhile, the milder variola minor persisted until the 1930s.

Later, the most notable wave was the 1947 New York City smallpox outbreak, which led to a massive vaccination campaign where an estimated 4.4 million people were vaccinated in less than a month.

By 1949, endemic cases of smallpox had ceased in the United States. However, by 1966, smallpox remained a pressing issue in less developed nations, with endemic smallpox cases in 33 countries.

Following intense debate, the World Health Assembly sanctioned a budget of $2.4 million in 1966 to launch a global eradication campaign over the next decade.

New Yorkers receive free smallpox vaccinations after twelve cases were reported in the state, April 1947. 

Any Direct Evidence of Vaccine Efficacy?

Are there any clinical trials comparing a smallpox-vaccinated group with an unvaccinated group of the same size? Is there direct evidence from the scientific literature substantiating that vaccination programs have played a crucial role in eradicating smallpox waves? No such evidence was found.

A 2017 WHO report, “Operational framework for the deployment of the WHO smallpox vaccine emergency stockpile in response to a smallpox event,” states that the “vaccine was effective in preventing smallpox infection in 95% of patients vaccinated during the eradication campaign.”

The original source for this claim appears to be from this 2003 paper: “Smallpox: Clinical Highlights and Considerations for Vaccination.”

Sourced from four articles, Dr. Mahoney’s paper, states, “Vaccine efficacy is 95% among vaccinees in whom a 1-2 cm loculated and umbilicated pustule (called a Jennerian pustule) is noted 6-8 days after inoculation.”

The first article is a 1999 JAMA paper by Henderson DA, et al. “Smallpox as a Biological Weapon: Medical and Public Health Management.” The only sentence in this paper referring to 95 percent is: “More than 95% developed a Jennerian pustule.” However, no direct source was provided for this statement.

The second reference cited by Dr. Mahoney is from a smallpox vaccination update from the CDC’s vaccine advisory committee, “Vaccinia (Smallpox) Vaccine Recommendations of the Immunization Practices Advisory Committee (ACIP).” ACIP states, “After percutaneous administration of a standard dose of vaccinia vaccine, >95% of primary vaccinees (i.e., persons receiving their first dose of vaccine) will develop neutralizing or hemagglutination inhibition antibody at a titer of greater than or equal to 1:10.”

The source for this statement is cited from a 1977 study published in the Journal of Infectious Diseases, which appears to be the source of the “95% efficacy” claim made in 2017 by the WHO.

This study was conducted by nine researchers from the Department of Pediatrics, University of California at San Diego and Los Angeles, and supported by the NIH.

The prestigious study involving a group of 786 children looked at the effectiveness and side effects of four smallpox vaccines given at different concentrations. Results showed that three licensed vaccines (New York City Board of Health strains grown in calf lymph or chorioallantoic membrane, and the Lister vaccine) were similarly effective.

Vaccine effectiveness was assessed by the vaccinee’s response, especially by observing any significant reactions around the tenth day, typically involving a central lesion occurring after the seventh day.

The skin reaction several weeks after smallpox vaccination was used for evaluation of the efficacy of smallpox vaccination. 

The WHO’s assertion of 95 percent efficacy appears to be grounded in the fact that 97 percent of children exhibited both a “major reaction” (take) and a serologic take. However, this doesn’t constitute direct evidence of the vaccine’s role in eradicating smallpox disease; it merely indicates the presence of a scar on the skin and an antibody response in the blood among vaccinated individuals.

An additional line of evidence is that vaccinated individuals retain immune memory, enabling their lymphatic cells to potentially respond to the smallpox virus if encountered in the body.

Regardless of skin take, serological take, or immune memory, it’s important to note that these observations belong to indirect support rather than direct clinical protection. There is an undeniable gap between the investigative data and the statement that smallpox was eradicated by the vaccine.

In conclusion, even though the WHO claims that smallpox was eradicated by the vaccine, it is surprisingly disappointing that there is no solid data to support this historical statement. On the contrary, there are numerous contradictory examples. Furthermore, there is a significant lack of evidence to support the smallpox vaccine claim of 95 percent efficacy, a narrative propagated by authorities for the past 200 years!

Why Smallpox Vaccines Have Not Worked

Why are smallpox vaccines not as effective as we may have thought?

The answer resides in two fundamental components of our immune system: natural or innate immunity versus adaptive immunity.

Our body’s immune system can be roughly separated into five layers. The first three layers are considered innate or natural immunity, which includes our skin, nose, and eyes; the mucosal epithelial cells in the respiratory or gastroenterological tracks which secrete powerful antiviral proteins such as interferon; and the innate immune cells such as natural killer cells and macrophages capable of eradicating invading viruses. The last two layers of immunity are specialized task forces. They involve T cells and B cells that can generate virus-specific cellular immunity or antibodies.

Five barriers of human immunity. 

A natural infection will induce a robust immune reaction from all five parts of our immune system, starting with our frontline immunity. However, when a vaccine is injected via an intramuscular route, like a COVID-19 vaccine, it often bypasses our first two lines of defense or frontline immunity. These kinds of partial training of the immune system often result in a weakened and biased immune response.

Vaccination is one type of biased training that distorts our innate immunity in the long run. We have not even mentioned the potentially harmful ingredients that vaccines often contain. Many people may think that direct contact via skin or clothing is the primary route of smallpox transmission. However, a large body of evidence suggests that fine particle aerosols have been the most frequent and effective mode of transmission. Accordingly, innate mucosal immunity plays a significant role in the overall defense against the smallpox virus.

Vaccination bypasses our pivotal mucosal immunity, resulting in incomplete immunity. Furthermore, the method of administering the smallpox vaccination also impacts the strength of vaccine-induced immunity. For example, the percentage of children developing neutralizing antibodies after receiving the smallpox vaccine percutaneously (within the skin layer) and subcutaneously (under the skin) was 83 percent and 23 percent, respectively. The more it activates innate immunity, the stronger response it induces.

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