Smallpox distribution of deaths by age (pre- and post-vaccination) 1580-1828

Before Jenner's work made vaccination commonplace at the turn of the nineteenth century, smallpox disproportionately affected children more than adults, with the share of deaths among those aged below ten years typically above ninety percent. This number even reached one hundred percent in some epidemics, such as in Chester, England in 1775; where all 202 smallpox deaths that year occurred in children below the age of ten, and 180 of these were in children below the age of five. Following the introduction of vaccination practices, which generally had the highest rates across Britain, Germany and Scandinavia, the share of smallpox cases in those aged above and below ten years saw a significant decrease, falling as low as 3.65 percent in one sample in London in 1822. The study in Marseilles is the only case shown here where the distribution of smallpox deaths was close to the figures shown in pre-vaccination Europe; this may be due to the political instability caused by Bourbon rule in post-Napoleonic France, as French authorities typically did not promote or enforce vaccination; a factor that would contribute greatly to the outbreak of the Great Smallpox Pandemic of the 1870s.