Smallpox in Grand Rapids, Michigan: What Residents Should Know

Smallpox is a serious infectious disease caused by the variola virus, an orthopoxvirus. Historically, it was one of the most feared and highly contagious viral illnesses worldwide. People with smallpox developed a widespread rash of blisters or pustules that eventually dried up and left permanent, often disfiguring, scars.

Although smallpox has been eradicated globally and there are no naturally occurring cases in Grand Rapids, Michigan, or anywhere in the world today, understanding the disease helps explain why vaccination and public health programs in West Michigan are so important.

Is Smallpox a Risk in Grand Rapids Today?

The last naturally occurring case of smallpox was detected in Somalia in 1977. In 1979, a commission of scientists certified that smallpox had been eradicated, and in 1980 the World Health Assembly officially endorsed this declaration.

Today:

  • Smallpox does not circulate in the community in Grand Rapids, Kent County, or anywhere else in the world.
  • Smallpox vaccination is not recommended for the general public in the United States and is not part of the routine immunization schedule used by providers in Grand Rapids (such as Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health).
  • Only two international laboratories are allowed to store small amounts of the smallpox virus:
    • Centers for Disease Control and Prevention (CDC) in Atlanta, USA
    • A WHO-designated laboratory in Koltsovo, Novosibirsk region, Russian Federation

Despite eradication, smallpox is still monitored as a potential bioterrorism threat, and U.S. public health agencies, including those serving Michigan, have emergency plans in place.

How Smallpox Affected the Body

While smallpox is no longer a natural threat in Grand Rapids, understanding its symptoms can help distinguish it from other rash illnesses and highlight why eradication was such a major achievement.

After exposure, the variola virus usually incubated in the body for 7 to 17 days (on average about 12 days) without causing symptoms.

Common Symptoms of Smallpox

Initial symptoms resembled many viral infections and could include:

  • High fever
  • Severe headache
  • Muscle aches and pains, especially in the back
  • Feeling very unwell and confined to bed
  • A non-specific red rash starting on the face, then spreading to the body and limbs

Over time, the rash progressed in stages:

  1. Red spots (macules) appeared on the face and spread to the arms, legs, and trunk.
  2. These evolved into raised bumps (papules).
  3. The bumps filled with fluid and became blisters or pustules.
  4. The pustules then split and crusted over, forming scabs.
  5. Eventually, the scabs fell off, often leaving permanent scars.

Death could occur if the virus attacked the circulatory system, bone marrow, or respiratory system. Before eradication, millions of people died annually worldwide, including many in climates similar to Michigan’s.

Smallpox and the Birth of Vaccination

Smallpox played a central role in the development of modern vaccines that protect people in Grand Rapids today.

Edward Jenner and Cowpox

In the 18th century, English physician Edward Jenner observed that milkmaids who had previously been infected with cowpox (a related but mild disease) rarely developed smallpox. He hypothesized that cowpox infection provided protection against smallpox.

Jenner tested his theory by:

  • Deliberately infecting a boy with cowpox, using material from a milkmaid’s cowpox pustule.
  • Later exposing the boy to smallpox multiple times.

The boy did not get smallpox. This was the first documented example of vaccination. The term “vaccine” comes from the Latin word vacca, meaning cow.

At that time, scientists did not yet understand viruses or bacteria, but Jenner’s work laid the foundation for the vaccines that are now routinely used by healthcare providers in Grand Rapids.

Development of the Smallpox Vaccine

Building on Jenner’s observations, researchers created an effective smallpox vaccine using a related virus called vaccinia. Different formulations of this vaccine were used until the 1970s.

In 1967, the World Health Organization (WHO) launched a global campaign to eradicate smallpox through:

  • Widespread vaccination
  • Careful surveillance
  • Rapid response to outbreaks

Within 12 years, smallpox was eradicated worldwide.

Smallpox as a Potential Biological Weapon

Although natural smallpox transmission has stopped, experts have considered the possibility that the virus could be used as a biological weapon. While this is believed to be unlikely, governments and public health systems, including those serving Michigan, have planned for such emergencies.

In the United States:

  • A limited supply of smallpox vaccine is kept in reserve.
  • These vaccines would be used for:
    • Essential medical and emergency personnel
    • Close contacts of any confirmed case, if an outbreak were to occur

Hospitals in Grand Rapids—such as Spectrum Health Butterworth Hospital, Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health—work closely with the Kent County Health Department and Michigan Department of Health and Human Services (MDHHS) to follow federal emergency preparedness guidelines.

Why Immunization Still Matters in Grand Rapids

Even though you do not need a smallpox vaccine in Grand Rapids, immunization remains one of the most effective and affordable ways to prevent many other serious infectious diseases.

Public health data show that vaccination programs have dramatically reduced diseases nationwide and in Michigan. For example, cases of invasive Haemophilus influenzae type b (Hib) disease in the U.S. have dropped by more than 90% since the Hib vaccine was introduced in the early 1990s. Similar trends are seen across Michigan, including West Michigan communities like Grand Rapids.

This is especially important in a region with:

  • Cold, long winters that push people indoors, increasing the spread of respiratory infections
  • A diverse and growing population of more than 200,000 in the metro area
  • Seasonal health challenges, including flu, RSV, and other respiratory viruses that can stress local healthcare systems

Routine vaccines help protect residents and reduce hospitalizations at local facilities.

How Doctors Decide Which Vaccines You Need: The HALO Framework

Healthcare providers in Grand Rapids often use the HALO framework to guide vaccine recommendations. HALO stands for:

  • H – Health
  • A – Age
  • L – Lifestyle
  • O – Occupation

Health

Certain health conditions can make you more vulnerable to vaccine-preventable diseases. You may need additional or more frequent vaccines if you have:

  • Premature birth history
  • Asthma
  • Diabetes
  • Heart disease
  • Chronic lung disease
  • Kidney disease
  • Spleen problems or removal of the spleen
  • Down syndrome
  • HIV or other conditions that weaken the immune system

In Grand Rapids, where winter respiratory illnesses are common, people with chronic lung or heart conditions are especially encouraged to stay current with vaccines like influenza and pneumococcal.

Age

Different ages require protection from different diseases. The U.S. Centers for Disease Control and Prevention (CDC) and MDHHS provide immunization schedules for:

  • Infants and children
  • Adolescents
  • Adults
  • Older adults
  • People at higher risk of certain infections

Most recommended vaccines for children and some high-risk groups are available at low or no cost through programs coordinated by:

  • Local pediatric and family medicine clinics
  • The Kent County Health Department
  • Community health centers in Grand Rapids

Lifestyle

Your lifestyle and activities can affect your vaccination needs. You may benefit from additional or more frequent immunizations if you:

  • Travel overseas, especially to regions with vaccine-preventable diseases
  • Are planning a pregnancy or are pregnant
  • Have multiple sexual partners or certain sexual exposures
  • Smoke
  • Play contact sports that may expose you to another person’s blood

For residents of Grand Rapids who travel frequently for work or recreation, especially outside the U.S. or around the Great Lakes region, travel clinics and primary care providers can review recommended vaccines before you go.

Occupation

Your job can also increase your risk of exposure to infectious diseases. In Grand Rapids, people working in the following areas should discuss their vaccination status with a healthcare provider:

  • Healthcare (hospitals, clinics, long-term care facilities)
  • Aged care and nursing homes
  • Childcare and early education centers
  • Emergency services (EMS, fire, police)
  • Sewerage and waste management
  • Public health and laboratory work

Some employers in West Michigan help cover the cost of recommended vaccines for their employees, especially in healthcare and emergency services.

Where to Get Vaccines and Public Health Support in Grand Rapids

If you live in Grand Rapids or the surrounding Kent County area and want to review your immunizations (including questions about smallpox preparedness), you can contact:

  • Your primary care provider or GP
    • Family medicine or internal medicine clinics at Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health
  • Kent County Health Department
    • Provides immunization clinics, travel vaccines, and records review
  • Grand Rapids Public Health and community health centers
    • Offer low-cost or sliding-scale vaccines for eligible residents

Bringing your immunization record to your appointment will help your provider determine which vaccines you may need.

Key Points for Grand Rapids Residents

  • Smallpox is caused by the variola virus, an orthopoxvirus.
  • Smallpox has been eradicated worldwide; there are no natural cases in Grand Rapids, Michigan, or anywhere else today.
  • Small stocks of smallpox virus remain in two designated international laboratories for research and security.
  • Smallpox vaccination is not part of routine immunization in the United States and is not recommended for the general public in Grand Rapids.
  • Smallpox played a critical role in the development of vaccination, leading to the modern vaccines that protect Grand Rapids residents from many diseases.
  • Immunization programs are among the safest, cheapest, and most effective preventive health measures, especially important in Michigan’s cold winters when infectious diseases spread more easily.
  • Your vaccine needs depend on Health, Age, Lifestyle, and Occupation (HALO)—talk with a local healthcare provider or the Kent County Health Department to ensure you are up to date.

If you have questions about vaccines, smallpox preparedness, or infectious disease prevention in Grand Rapids, schedule an appointment with your doctor or contact the Kent County Health Department for guidance.