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Smallpox vaccine scars: What they look like and why

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The Story Behind a Scar: A Forgotten Mark of a Vanished Disease

When I was a child, I remember being oddly curious about a small, circular scar on my mother’s upper arm.

It sat just below her shoulder—a ring of tiny indentations surrounding a deeper mark. At the time, I couldn’t explain why it fascinated me, but the image stuck.

As I grew older, like many childhood curiosities, it faded into the background. The scar never disappeared, of course, but I stopped thinking about it.

Maybe I had asked about it once and forgotten the explanation, or maybe I never asked at all.

Years later, on a summer afternoon, I was helping an elderly woman off a train when I noticed something startling: she had the exact same scar in the exact same place.

It was like déjà vu. That moment reawakened my old curiosity, but with the train ready to depart, I didn’t have time to ask her about it. So I called my mother.

She wasn’t surprised by my renewed interest.

In fact, she reminded me that she had explained the scar’s origin before—more than once, apparently—but I had never retained the information. The answer was simple: it was the result of a smallpox vaccination.

Smallpox, once one of the most feared viral diseases in human history, caused severe rashes, high fevers, and, in many cases, death.

According to the Centers for Disease Control and Prevention, it killed about 3 out of every 10 people who contracted it. Survivors were often left with permanent scars.

Fortunately, a successful global vaccination effort led to smallpox being eradicated in many parts of the world.

In the United States, the virus was considered eliminated by 1952, and routine smallpox vaccinations were discontinued by 1972.

But for those vaccinated before then, the scar left behind is a physical reminder of a time when smallpox was a real threat. In a way, it became a visible badge of immunity—a kind of early “vaccine passport” that confirmed you’d been protected.

Why Did the Smallpox Vaccine Leave a Scar?
Unlike most modern vaccines, which are given with a single needle prick, the smallpox vaccine was delivered using a specialized tool called a bifurcated (two-pronged) needle.

The vaccine wasn’t injected deep into muscle, but applied to the skin with multiple quick punctures that reached just below the surface.

This process triggered the body to react. Within a few days, a small bump would appear, which then developed into a blister.

That blister would eventually break, scab over, and leave a scar behind.

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