Smallpox: The Geopolitical Impact of Smallpox

This chapter looks at selected events throughout the course of history in which smallpox has played a decisive role. The story of smallpox is interwoven with the history of human migrations and wars, dramatically favoring one population or army over another. Smallpox actually changed the course of history by killing generals and kings or decimating their enemies. That history is presented as context for the chapter’s second part, which assesses whether or not there is a need to revaccinate today: the issues, risks, and benefits involved. Despite the eradication of smallpox as a disease, could the virus return? Since the virus does not linger in the form of a persistent infection, it is amenable to permanent eradication—that is to say, removal from the world. However, because the virus no longer circulates in any community, the numbers of never-vaccinated or never-infected susceptible individuals increase continually. Further, complete or efficient immunity of those previously vaccinated is believed to wane in 10 to 20 years. Consequently, the pool of highly susceptible individuals continues to expand enormously.