Vaccination began to be practised in Sweden in the year 1801. It was at first viewed with distrust by some of the leading medical authorities, but grew so rapidly in favour, that the medical board in 1803 ventured to make proposals for its general introduction. By Royal Letters in 1804 and 1805 measures were decreed for the encouragement of Vaccination; and in the almanacs for 1806, information and advice were inserted concerning “the new and certain means for the prevention and extirpation of Smallpox.” Nevertheless, the practice made way but slowly into the confidence of the common people, and not until 1812 did a committee of the Diet go so far as to recommend its compulsory adoption. The principle of compulsion was affirmed by the Diet in 1815, leading to a Royal Decree of 6th March, 1816, whereby Vaccination was made obligatory under penalty of fine and imprisonment.

Subsequently, the law was modified, but never relaxed. Whilst the rite was obligatory, it was offered gratuitously, and public vaccinators, usually parish clerks and midwives, were appointed throughout the land, and stimulated to exertion by special rewards. Vaccination was made a condition of admission to school, and was placed by the clergy on a level with baptism and confirmation. Wherefore, in course of time, it has come to pass that Sweden is described as “the best vaccinated country in the world.”

To this result the recognised interest of the Swedish clergy in medical practice largely contributed. They were not slow to perceive a fresh line of business in vaccination. Archbishop Lindblom, among others, was extremely zealous in promoting the practice in his diocese, and from a correspondence between the Consistory of Upsala and the Medical Board, it appears that the competition between the physicians and the parsons was severe. The Consistory complained that the rewards for vaccination energy were more liberally bestowed on medical men than on the deserving clergy, and that it was unfair to insist on the clergy taking out a license to vaccinate, ending with the reproach that the mishaps of some medical men had so alarmed the people in certain districts, that very few were willing to avail themselves of the wonderful prophylactic. The Board replied, that they were aware that mistakes had occurred through the use of spurious cowpox, as proved by the outbreak of smallpox afterwards; but, at the same time, what better check could be devised on incompetent practitioners than a medical license? The right of the clergy to vaccinate was not contested, but only that they should possess some recognised qualification. The extent of the ecclesiastical operations in cowpox appears from the return of the Archbishopric of Upsala, which showed that from 1804 to the end of 1810 there were 33,298 persons vaccinated, of whom 7,025 were inoculated by clergy, 20,000 by church officers, and 6,273 by medical men and others. It was by the clergy and the doctors that the project of compulsion was initiated. In a letter from the Medical Board to the King in 1810, complaint was made that “the public in Sweden do not in all places manifest the care and zeal which might be expected from sensible and tender parents in applying for, or allowing to be applied, the precious means of salvation provided for their children’s good looks and future health.” In 1814, the same Board wrote that “several of the Bishops who take the deepest interest in the spread of vaccination, have expressed their conviction that certain well-devised penalties have become as necessary as regards the ignorant masses as encouragements are useful”; and as late as 1815, the Board had to testify against the “sluggishness and indifference prevalent among the less enlightened classes.”

Compulsion was, therefore, enacted in 1816 to overcome the inertia of the lower orders, the mass of the people who at all times yield the largest crop of smallpox.

“Smallpox was exterminated in Sweden by vaccination,” is a common saying. Moore, in his History of Vaccination, published in 1817, after describing the various measures taken, observed—

It is superfluous to add, that by such a concurrence of virtuous exertions, Smallpox was quickly suppressed in Sweden.

Ere proceeding to inquire whether smallpox was thus suppressed, I would call attention to the hands by which vaccination was administered in Sweden. It is the custom at this day to describe vaccination as a delicate operation, and to attribute subsequent smallpox to some irregularity or defect in its performance; and yet here we are asked to contemplate a whole nation delivered from smallpox, the vaccinators being chiefly priests, clerks, and midwives. What does it mean? Is it that any sort of vaccination is good when smallpox does not follow, and that any sort is bad when smallpox does follow? If smallpox had not ceased out of the land, would it then have been said, “What wonder, considering the character of the vaccinators”?

To the assertion that smallpox in Sweden was exterminated by vaccination, the answer is an unqualified contradiction. It is not true; it is demonstrably untrue. Smallpox was declining in Sweden before vaccination was heard of, and the fall continued irrespective of its influence. Look at the figures. Here we have the returns of smallpox mortality in Sweden during the last sixteen years of the past, and the first sixteen years of the current century, up to the time when vaccination was made compulsory—

Year.Deaths
from
Smallpox.		Year.Deaths
from
Smallpox.
17855,07718016,057
178667118021,533
17871,77118031,464
17885,46218041,460
17896,76418051,090
17905,89318061,482
17913,10118072,119
17921,93918081,814
17932,10318092,404
17943,9641810824
17956,7401811698
17964,5031812404
17971,7331813547
17981,3571814308
17993,7561815472
180012,0321816690
——————
Total,66,866Total23,376
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