Edward Jenner's work on smallpox, published in 1797, was the first time that any scientific findings about vaccination were presented to the wider medical community. Within a few short years of this publication, vaccination had been practiced in most European countries, and the impact was beginning to show almost immediately; particularly in countries such as Sweden and England. As vaccination practices spread, the severity and frequency of smallpox pandemics declined, and the disease ceased to be endemic in some regions.
Iceland leads the way
Epidemics had played a significant role in Iceland's history and development throughout the pre-vaccination era. The country's geographical location meant that viruses did not spread from other countries as frequently as they did on Europe's mainland, however, this also meant that generations would reach adulthood without developing any immunity to these diseases. When these factors were coupled with Iceland's highly concentrated population, this enabled epidemics to spread rapidly throughout the population with devastating effect. The most famous of these epidemics was between 1707 and 1709, where a ship from mainland Europe brought smallpox to Iceland, and the resulting outbreak killed over one third of the entire population.
For these reasons, Iceland (although a dominion of Denmark at the time) became the first country in the world to introduce mandatory vaccination, in 1802. The Great Smallpox Pandemic of the 1870s was the last outbreak of the disease to reach pandemic level across Europe. Unbeknownst at the time, this would mark the last ever recorded case of naturally occurring smallpox in Iceland, in 1872. This made Iceland the first country in the world to eradicate the disease on a national level; the same factors that had allowed smallpox to be so devastating to Iceland's population in the past (i.e. distance from mainland Europe and a highly concentrated population) had become the reason why vaccination was so effective in the nineteenth century.
The progress of elimination
After Iceland's success, it would be another 23 years before the final smallpox cases would be recorded in any other European countries, with Sweden and Norway being the only other countries to eliminate the disease in the nineteenth century. In 1904, French Guiana was the first non-European territory to eradicate the virus, and Oceania* became the first continent to do so; with the last recorded cases in New Zealand and Australia taking place in 1914 and 1917 respectively. The United States recorded its final naturally occurring case of smallpox in 1948, and the final European case was in Portugal in 1953. Smallpox proved more difficult to eradicate in less-developed continents, due to a variety of barriers; such as dense populations and limits in infrastructure (the lack of roads made it especially difficult to combat the disease in Sub-Saharan Africa). The World Health Organization launched the Smallpox Eradication Programme in 1966, and after a number of aggressive vaccination and containment campaigns, the final case of naturally occurring smallpox was recorded in Somalia in 1977. For the next two years, scientists continued to monitor the global situation, but could find no further cases or outbreaks of the disease. On May 08. 1980, the World Health Assembly declared that smallpox had been eradicated, making it the first (and only, as of 2020) human disease to have been eradicated. This was one of the most significant and important medical developments in human history, and it has paved the way for the eradication of other communicable diseases, such as polio and measles; which are expected to be wiped out in the coming decades.
Number of countries in which naturally occurring cases of smallpox were eradicated between 1872 and 1977
Characteristic
Number of countries
1977
147
1976
146
1975
144
1974
141
1973
140
1972
139
1971
133
1970
129
1969
124
1968
119
1967
111
1966
110
1965
105
1964
100
1963
100
1962
97
1961
93
1960
90
1959
85
1958
81
1957
81
1956
79
1955
78
1954
77
1953
75
1952
73
1951
72
1950
66
1949
65
1948
63
1947
57
1946
56
1945
55
1944
55
1943
53
1942
53
1941
53
1940
53
1939
53
1938
52
1937
51
1936**
51
1935
35
1934
35
1933
34
1932
33
1931
33
1930
33
1929
33
1928
33
1927
33
1926
33
1925**
31
1924
25
1923
22
1922
18
1921
14
1920
14
1919
10
1918
10
1917
9
1916
8
1915
8
1914
8
1913
7
1912
7
1911
7
1910
7
1909
7
1908
7
1907
7
1906
6
1905
6
1904
6
1903
5
1902
5
1901
5
1900
4
1899
3
1898
3
1897
2
1896
2
1895
2
1894
1
1893
1
1892
1
1891
1
1890
1
1889
1
1888
1
1887
1
1886
1
1885
1
1884
1
1883
1
1882
1
1881
1
1880
1
1879
1
1878
1
1877
1
1876
1
1875
1
1874
1
1873
1
1872
1
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*No data available for many Caribbean countries, micronations, Pacific Islands (no known cases in the twentieth century) and vast but sparsely populated areas (i.e. Mongolia and Greenland).
**The reason for these sharp increases is because successor states have been allocated the eradication date of their predecessor states (i.e. former Soviet or Yugoslav countries).
The full list of countries and the year of eradication is as follows:
Iceland - 1872
Sweden - 1895
Norway - 1898
Netherlands - 1900
Denmark - 1901
French Guiana - 1904
Ireland - 1907
New Zealand - 1914
Australia - 1917
Madagascar - 1918
Bhutan - 1920
Costa Rica - 1920
Israel - 1920
Suriname - 1920
Albania - 1922
Finland - 1922
Germany - 1922
Panama - 1922
Austria - 1923
Bulgaria - 1923
Hungary - 1923
Romania - 1923
Czechia - 1924
Nicaragua - 1924
Slovakia - 1924
Bosnia and Herzegovina - 1925
Croatia - 1925
Jordan - 1925
Macedonia - 1925
Serbia - 1925
Slovenia - 1925
Belgium - 1926
Switzerland - 1926
Poland - 1933
United Kingdom - 1934
Armenia - 1936
Azerbaijan - 1936
Belarus - 1936
Estonia - 1936
France - 1936
Georgia - 1936
Kazakhstan - 1936
Kyrgyzstan - 1936
Latvia - 1936
Lithuania - 1936
Moldova - 1936
Russia - 1936
Tajikistan - 1936
Turkmenistan - 1936
Ukraine - 1936
Uzbekistan - 1936
El Salvador - 1938
Belize - 1939
Canada - 1944
Greece - 1944
North Korea - 1946
Italy - 1947
Egypt - 1948
Libya - 1948
Morocco - 1948
Spain - 1948
Tunisia - 1948
United States - 1948
Lebanon - 1949
Philippines - 1949
Syria - 1950
Guatemala - 1951
Guyana - 1951
Japan - 1951
Mexico - 1951
Sri Lanka - 1951
Turkey - 1951
Honduras - 1952
Laos - 1953
Portugal - 1953
Chile - 1954
South Korea - 1954
Namibia - 1955
Venezuela - 1956
Guinea-Bissau - 1957
Uruguay - 1957
Angola - 1959
Cambodia - 1959
Djibouti - 1959
Vietnam - 1959
Bolivia - 1960
Equatorial Guinea - 1960
Malaysia - 1960
Paraguay - 1960
Yemen - 1960
Algeria - 1961
China - 1961
Saudi Arabia - 1961
Lesotho - 1962
Mauritania - 1962
Oman - 1962
Thailand - 1962
Central African Republic - 1963
Ecuador - 1963
Senegal - 1963
Chad - 1965
Colombia - 1965
Congo - 1965
Gabon - 1965
Myanmar - 1965
Argentina - 1966
Cote d'Ivoire - 1966
Gambia - 1966
Peru - 1966
Swaziland - 1966
Ghana - 1967
Burkina Faso - 1968
Cameroon - 1968
Guinea - 1968
Liberia - 1968
Mali - 1968
Niger - 1968
Uganda - 1968
Zambia - 1968
Benin - 1969
Kenya - 1969
Mozambique - 1969
Sierra Leone - 1969
Togo - 1969
Burundi - 1970
Nigeria - 1970
Rwanda - 1970
Tanzania - 1970
Zimbabwe - 1970
Brazil - 1971
Democratic Republic of Congo - 1971
Malawi - 1971
South Africa - 1971
Afghanistan - 1972
Indonesia - 1972
Iran - 1972
Iraq - 1972
South Sudan - 1972
Sudan - 1972
Botswana - 1973
Pakistan - 1974
Bangladesh - 1975
India - 1975
Nepal - 1975
Eritrea - 1976
Ethiopia - 1976
Somalia - 1977
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OWID. (March 30, 2020). Number of countries in which naturally occurring cases of smallpox were eradicated between 1872 and 1977 [Graph]. In Statista. Retrieved February 17, 2025, from https://www.statista.com/statistics/1108182/smallpox-eradication-by-country/?__sso_cookie_checker=failed
OWID. "Number of countries in which naturally occurring cases of smallpox were eradicated between 1872 and 1977." Chart. March 30, 2020. Statista. Accessed February 17, 2025. https://www.statista.com/statistics/1108182/smallpox-eradication-by-country/?__sso_cookie_checker=failed
OWID. (2020). Number of countries in which naturally occurring cases of smallpox were eradicated between 1872 and 1977. Statista. Statista Inc.. Accessed: February 17, 2025. https://www.statista.com/statistics/1108182/smallpox-eradication-by-country/?__sso_cookie_checker=failed
OWID. "Number of Countries in Which Naturally Occurring Cases of Smallpox Were Eradicated between 1872 and 1977." Statista, Statista Inc., 30 Mar 2020, https://www.statista.com/statistics/1108182/smallpox-eradication-by-country/?__sso_cookie_checker=failed
OWID, Number of countries in which naturally occurring cases of smallpox were eradicated between 1872 and 1977 Statista, https://www.statista.com/statistics/1108182/smallpox-eradication-by-country/?__sso_cookie_checker=failed (last visited February 17, 2025)
Number of countries in which naturally occurring cases of smallpox were eradicated between 1872 and 1977 [Graph], OWID, March 30, 2020. [Online]. Available: https://www.statista.com/statistics/1108182/smallpox-eradication-by-country/?__sso_cookie_checker=failed