In the last decade of the 19th century, some hundred years after the introduction of the smallpox vaccine, a heated controversy broke out in London regarding the compulsory vaccination of children against the disease. Amongst those affected by the legislation, mandating the immunization of children against smallpox was a Jewish father who was eventually imprisoned for refusing to have his son vaccinated. His grounds for refusal were his religious beliefs and it is with his case and its aftermath that the present article is concerned. The two major protagonists in the controversy were Chief Rabbi of England, Dr. Herman Adler and Mr. J. H. Levi. According to the Chief Rabbi, members of the Anglo-Jewish community were required to comply with the law of the land and act in accordance with mainstream medical opinion regarding the vaccination of their children as a matter of their Jewish faith. Levi who was a prominent economist at London University and a champion of liberalism and individual freedom, strongly opposed the Chief Rabbi's ruling on Jewish as well as general grounds. The debate between the two protagonists as it emerges from newspaper clippings and articles of the period is similar in many ways to the contemporary vaccination controversy in both London and Israel. One salient feature of the 19th century debate is the failure of the health authorities to publish precise and ongoing reports on the importance and effectiveness of vaccination throughout the year and not only prior to anticipated outbreaks of the disease. One of the lessons to be learned from the present article is the need for the medical establishment to acquire expertise in the areas of communication and media in order to deal successfully with the phenomenon of vaccine refusal. Amongst the issues that would need to be confronted is that of the halakhic objections, if any, to compulsory vaccination, which is a central theme of this article.