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–by Leah Shafer, USCHS intern

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the President of the United States be, and he is hereby authorized to appoint an agent to preserve the genuine vaccine matter, and to furnish the same to any citizen of the United States, whenever it may be applied for, through the medium of the post office…

Sec 2.And be it further enacted, That all letters or packages not exceeding half an ounce in weight, containing vaccine matter, or relating to the subject of vaccination, and that alone, shall be carried by the United States’ mail free of any postage, either to or from the agent who may be appointed to carry the provisions of this act into effect…

Approved, February 27, 1813.”

With this legislation, eight months into the War of 1812, the U.S. government took its first step in taking responsibility for public health. “An act to encourage vaccination” established a National Vaccine Agency and mandated that any citizen in want of a smallpox vaccine (the only developed vaccine at the time) was entitled to have it. The act furthermore decreed that vaccine packages weighing less than half an ounce shipped in the mail would not require postage, making the vaccine more accessible to all Americans.

Edward Jenner (1749–1823). (National Library of Medicine)

For centuries, smallpox had been one of the deadliest diseases facing humans: highly contagious, killing 30% of those affected, and wiping out entire Native American populations. In 1796, Edward Jenner, an English physician and scientist, discovered that humans inoculated with the cowpox virus, a much milder relative of smallpox, were immune to smallpox. His consequent vaccine was revolutionary in terms of treatment of infectious diseases. In 1800, Benjamin Waterhouse, a Harvard professor, introduced this new smallpox vaccine to the United States. Waterhouse wrote letters to then-President John Adams, his former roommate, and Thomas Jefferson about the discovery’s potential. “Every friend of humanity must look with pleasure on this discovery, by which one evil more is withdrawn from the condition of man,” Jefferson replied.

Jefferson continued to express support for vaccination throughout his presidency, helping lead to the approval of “An Act to encourage vaccination” under President Madison. Introduced by Representative John Rhea of Tennessee on January 15, 1813, the act was passed by the House on February 19, by the Senate just six days later on February 25, and signed into law on February 27, 1813.

But even after this scientific breakthrough and inception of U.S. government involvement in public health, vaccines were not universal, and smallpox remained a very real threat to Americans. Local governments had a difficult time raising the taxes to pay for vaccinations. Even worse, as the vaccine grew more successful, later generations who did not remember the threat of smallpox were reluctant to receive a vaccine. The procedure was painful, bloody, and left a small scar. State governments debated whether to make vaccines compulsory, and it was not until 1905, in the case of Jacobson v. Massachusetts, that the Supreme Court declared it constitutional for state governments to require vaccines in order to protect the health and safety of their citizens.

It is estimated that 300 million people worldwide died from smallpox in the 20th century alone—a number that surely would have been lower had more people looked “with pleasure on this discovery” in the century before. However, this mortality rate is certainly lower than it would have been without Jenner’s discovery. Between 1811 and 1820, the London Bills of Mortality recorded 7,858 deaths from smallpox, down from 18,447 between 1791 and 1800, the last decade before vaccination. And today, smallpox has been completely eradicated since May 1980. The smallpox vaccine was so effective that it has become obsolete, but we can still see its legacy in the fourteen other diseases for which American children receive vaccinations and in the growing government responsibility in public health and security.

Works Cited

Calgrove, James. “Immunity for the People: The Challenge of Achieving High Vaccine Coverage in American History.” Public Health Reports 122, no. 2 (2007): 248-257.

“History of Smallpox: Timelines.” The History of Vaccines. Last modified 2013. (accessed May 2, 2013).

U. S. Congress. Statutes at Large. 12th Cong., 2nd sess., February 27, 1813. From Library of Congress. (accessed May 2, 2013).

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