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Smallpox: A Great and Terrible Scourge banner
Smallpox: A Great and Terrible Scourge written in white lettering with a black border Public Health Service Historian History of Medicine Division National Library of Medicine National Institutes of Health The Threat written in red letters. Variolation written in red letters. Vaccination written in red letters. Resistance to Vaccination written in red letters. The 20th Century Threat written in red letters. Campaign to Eradicate written in red letters. Obstacles and Struggle written in red letters. Success written in red letters.

Obstacles and Struggle

Vaccinators still had to overcome religious and cultural barriers. Medical demands often clashed with ethical considerations as in India. There, one religious leader’s opposition to vaccination ensured the continued presence of smallpox. After much debate, WHO leaders forcibly vaccinated the religious leader, opening up the door for the vaccination of his followers and the successful containment of smallpox. While forcible vaccination worked in some instances, it caused riots in other areas.

The chaos which accompanied war tended to raise suspicions regarding the WHO team. WHO vaccinators were threatened at gun-point and in civil-war torn Nigeria, ceasefires were specially negotiated to allow for the transfer of vaccine.

WHO members vaccinated in a concentric ring around an outbreak but this required prompt reporting of all smallpox cases. Cash bounties were paid to people who reported smallpox cases. Suspect cases were then investigated and a WHO team moved in to vaccinate and arrest the outbreak.

World Health Organization Smallpox poster communicated using images, not written text. Vignettes warn of the dangers of smallpox and the need for vaccination.

Detail from a World Health Organization Smallpox poster communicated using images, not written text. Vignettes warn of the dangers of smallpox and the need for vaccination.

Low levels of literacy in smallpox infested regions meant that WHO needed to communicate using images, not written text. Posters such as this one were used to educate people on the dangers of smallpox and the need for vaccination.



Predominantly black poster with multicolor lettering. Visual image is an abstract pattern formed by dots of varying sizes. Title and caption below image. Caption is presented in both English and French. A reward is offered for the first person reporting an active smallpox case. The word smallpox is repeated all around the caption in several languages.

Front of Smallpox Recognition card featuring the head and shoulders full face view of a child with smallpox pustules.

The back of a Smallpox Recognition card featuring four images of a child with smallpox. The top two are the front and back images of a naked child with smallpox pustules cover its body. The bottom two images are the top and bottom detail of the right hand of the child showing the smallpox pustules.

The front and back of the WHO smallpox recognition card. The card, which portrays a patient with relatively mild smallpox, was widely used from 1971 to facilitate case detection in endemic countries.