Smallpox had been identified in public policy as something which could and should be eradicated; it killed adults as well as infants, both rich and poor.
Some 800 patients had been admitted during the past year to the Small Pox Hospital in Highgate. This was over ten percent more (88) than had ever been admitted. The record before that was in 1838, the start of a national epidemic during which almost 42,000 died. Legislation had followed in 1840 to set up a national system of voluntary vaccination; death rates then declined. Vaccination had been far from universal, however, varying considerably between Poor Law Unions and across the country. The rates of infant vaccination were much higher in London, for example. That was also true in the cities and crowded urban areas of the industrial North which had also suffered most in the earlier epidemic.
The incidence of smallpox in 1851 and 1852 was regarded as the possible start of another epidemic and there was growing pressure for further legislative action. Part of this pressure was coming from the London Epidemiological Society, a grouping of physicians and others interested in the causes of epidemic diseases and their prevention. Founded in 1850, the Society’s members were pioneers in the use of statistical evidence upon which to base actions to improve public health. A committee was put together to report on the state of small-pox and vaccination in England and Wales when compared to other countries, and thence upon the merits of compulsory vaccination.