Smallpox in Albania: history, epidemiology and prevention

Background: Smallpox is caused by the variola virus, a member of the Orthopoxvirus genus of the Poxviridae family. It is the only human disease eradicated worldwide, making it the most significant global public health. In May 2022, the Albanian Committee of Vaccination Experts recommended vaccination against smallpox to human subjects in close contact with confirmed monkeypox cases. Aim: The main aim of this review is to report the history of smallpox in Albania in terms of epidemiological background and vaccination, considering the changes in health policies during the years influenced by political and economic alliances. Methods: Data were obtained from the Albanian State Archive, focusing on records of the Institute of Public Health and the Ministry of Health as well as from the Archive Library’s Literature. A literature search was also performed in online databases. Results and conclusions: Vaccination against smallpox became mandatory for all age groups in Albania in 1947. Primary vaccination was carried out at 6 months of age, and three boosting doses were administered at the ages of 6-7, 11-12, and 18-19 years from 1953 to 1964. The elimination of smallpox in Albania was officially reported in 1966. Although the smallpox vaccine was produced in Albania by the Institute of Hygiene and Epidemiology in 1954, several other types of smallpox vaccine strains have been imported from other countries.