Smallpox death rate in selected European countries 1851-1900

In nineteenth century Belgium, smallpox vaccination was available but was never made compulsory. For this reason, the number of deaths due to smallpox fluctuated regularly (although data before 1864 is scarce*), and the Great Pandemic of the 1870s caused the number of smallpox deaths in Belgium to skyrocket to 4.2 thousand per million people in 1871. Several sources suggest that smallpox had a similar impact in the Netherlands throughout the early and mid-1800s, however the Netherlands introduced mandatory vaccination for all children who were to be enrolled in school in 1873, and following the Great Pandemic the Netherlands' death rate was much lower than that of Belgium. The last natural case of smallpox was recorded in the Netherlands in 1900 (making it the fourth country in the world to eradicate the disease on a national level), while the last endemic case of smallpox in Belgium occurred in 1926. Data for Italy and Hungary is also scarce throughout the century, however Hungary introduced mandatory vaccination and revaccination in 1887, while Italy did the same in 1888; over the next decade we can see that the average number of smallpox deaths in these countries decreased greatly, and endemic cases of smallpox were eliminated in Hungary in 1923, and in 1947 in Italy.