Public vaccination in England and Wales is generally assumed to have provided the blueprint for the development of the service in Ireland. At first glance, this analysis appears to fit the facts. In both countries, vaccination was first provided free of charge to the whole population through the poor law under the 1840 Vaccination Act. This was followed up by the introduction of compulsory vaccination—in England and Wales in 1853, in Ireland in 1863. Looked at in more detail, it is clear that after 1840, public vaccination followed a distinctive path in Ireland. Unlike England and Wales, where there were no major pieces of legislation between the 1840 and 1853 acts, establishing the provision of free vaccination and compulsory vaccination, in Ireland two important acts were passed, the 1851 Medical Charities Act and the 1858 Vaccination Act. After the introduction of compulsion in 1863, there were no further measures to enforce compulsion. Vaccination in Ireland has rarely been studied, reflecting a more general dearth of work on the history of medicine in Ireland. Even though Ronald Cassell describes the implementation of vaccination legislation in the context of poor law medical services, other histories of medical care make only passing reference to vaccination.

The next two chapters analyze the origins of Ireland's distinctive public vaccination service. They explore how the same groups—practitioners, government agencies, and MPs—who shaped public vaccination in England also influenced the development of the Irish service.