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The story of smallpox in Stuttgart is a clear example of how vaccination can make a significant impact. In the first 25 years shown here, the number of smallpox deaths averaged at 224 deaths per year, before a slight increase over the next five years to 274 deaths per annum. With the introduction of vaccination practices to Europe at the turn of the nineteenth century, a clear decrease can be observed in the next decade, dropping to 154 deaths per year between 1802 and 1806, and falling again to just two deaths per year between 1801 and 1811. In two of the next three five-year periods, the average number of smallpox deaths per year was zero. The state of Württemberg (of which Stuttgart was the capital) was one of the first in Europe to make vaccination compulsory, doing so in 1818; joining its south-German neighbors of Bavaria and Baden at the forefront of the fight to eradicate smallpox.