If smallpox got out, how bad would it be in modern times

No. Because that would be uncontrolled spread. With controlled vaccination you would use a location that doesn’t normally contact other people, like the upper arm or the top of the foot or some such, and then bandage it carefully to prevent spread.

Uncontrolled contact often involves touching an active site, then touching something else. If that something else is your eye you will be blinded by the resulting infection scarring up your cornea. As just one example of how this can go wrong. If that “something else” is someone with eczema you can potentially kill them. If that “something else” is someone with a weak immune system you might, kill them - or just leave them extensively scarred from a systemic rather than localized infection.

Allowing spread also allows for mutations in the vaccinia virus… which can lead to stronger/more contagious variants and lead to disease that is potentially harmful in its own right.

In other words - NOT recommended!

In the event of a vaccine shortage past history indicates very strict quarantine should be used.

That outbreak still killed 2 out of the 3 people infected. One of which had had a prior vaccine (although that was many years prior).

Okay, but what about having doctors do person-to-person vaccination if there aren’t enough doses available? Particularly for people who are likely to have been exposed.

In theory - yeah, you could. In the late 1700’s/early 1800’s some of that was, in fact, done, utilizing the pus from a vaccination site to vaccinate others. You risk passing other infections along, too, which is far from ideal. That’s why we started culturing vaccinia on its own and vaccinating from that supply rather than transferring pus between human beings.

A woman on another site has told the story about how her official smallpox vaccines in the 1950s didn’t “take”, but one day, she was looking after a toddler relative who had a healing vaccine scar, and he scratched her face, leaving a trail of smallpox vaccine scabs on her forehead and nose. She was very fortunate that it didn’t get into her eyes, and multiple dermatologist visits remedied it in the end. That baby later apologized profusely, and she told him that she had long since forgiven him, since he didn’t mean to do it.

As for that 1978 London outbreak, several passersby who walked by the building on the day that it happened later reported varying numbers of pustules on their own skin, without additional symptoms, meaning they’d contracted a (relatively) mild case themselves.

… In America.
I received on in 77 or so, and they were still doing them here until 1980 or so, I believe. So plenty of 40-somethings here in South Africa have them.

No longer true - some members of the armed forces and some first responders have been vaccinated in the US in recent years, down to 20-somethings at the time of their vaccinations. The idea is that if smallpox ever did get loose again there would be at least a small group of protected people in the country.

n/m, didn’t see this was an older thread

Is it possible they could mandate vaccination here by law, at least in certain circumstances? (Like, you aren’t allowed to attend school unless you have the vaccine?)

Where’s “here”?

If you mean someplace in the USA, we have plenty of mandatory vaccination laws already.

All of which contain an exception for anyone who claims they have a “religious” reason not to vaccinate. And religion being what it is in the USA, there can be no requirement to provide any sort of proof that this belief is actually held or has the slightest connection to anything any sane observer would believe is part of the religion you claim to espouse.

Not all allow religious exemptions. New York and a few other states only allow medical exemptions for school attendance.

This raises a concern I have: not so much smallpox itself but another animal Pox virus mutating into a virulent form that is lethal to humans.

I’m not sure why to specify pox specifically: Viruses from other animals mutating to infect humans is something that happens regularly, with all sorts of viruses. In fact, most of the viruses that afflict us (including COVID) probably came from other animals. And yes, it’s something that we should always have concern about, and be taking measures against.

Not disputing anything you said, but given the ubiquity of humans, that makes me wonder how often humans are breeding “better” viruses to pass on to animals.

With our global range and rapid transport, we could mutate a virus in humans that is communicable to, say, squirrels, then quickly spread it to squirrel populations all over the planet. If the effects on the squirrels were severe, they’d never know what hit them before they were extinct.

That’s what I’m thinking. (And yes, I’m talking the US). Require the vaccine, with only medical exemptions.

Considering that it’s fucking smallpox? C’mon.

I expect people would still fight mandatory vaccinations, even if it’s for fucking smallpox, given that few have any memory of it.

People would fight mandatory chocolate cake just to be contrary. Doubly so if QAnon told them to.

Even when smallpox was still causing epidemics there were people who resisted vaccination. There are ALWAYS people who resist vaccination.

The question isn’t whether there would be antivax people, the question is what level of threat is needed to get the intelligent people to develop the political will to pass a law stating that everyone is going to be held down by members of the military in public and forcibly injected with the vaccine while passersby shout insults at them. Like we should be doing with the covid vaccine right now. If we have another outbreak of anything at covid-level or worse while memories of 2020-2021 are still fresh, then the support will probably be there.

Wow, that sure as hell ain’t going to happen for something with the threat level of Covid.

No, but it did happen with smallpox - this article talks about people being vaccinated against their will.