We can therefore use the reproduction number to work out how many people we need to vaccinate to control an infection. Suppose an infection has an R of 5 in a fully susceptible population, as smallpox did, but we then vaccinate four out of every five people. Before vaccination, we’d have expected a typical infectious person to infect five other people. If the vaccine is 100 per cent effective, four of these people will now be immune on average. So each infectious person would be expected to generate only one additional case.