Smallpox in Richmond

The world’s first vaccine was developed to combat smallpox. Highly contagious and one of the deadliest diseases in human history, it killed three out of every ten of its victims. And it was widespread. Smallpox affected all classes—royalty, soldiers, enslaved people—but was particularly devastating to Indigenous people.

Regular smallpox outbreaks swept through Richmond from the 18th to the first part of the 20th century. Before 1796, doctors used a crude precursor to inoculation, called variolation, to try to control the spread. With variolation in the United States and Europe, a scab from someone infected with smallpox would be inserted under the skin of a healthy individual. During the American Revolutionary War, George Washington made sure his soldiers were treated with variolation. The procedure, in addition to being disgusting, could backfire. Variolation could lead to a deadly case. But soldiers so feared smallpox that if no medical supervision was available, it was not unheard of to simply lance a scab from an infected comrade and self-variolate.

This was the state of things before 1796, when an English scientist named Edward Jenner noticed that milkmaids who caught cowpox seemed immune from smallpox.  From there, he developed an effective smallpox vaccine from the slightly less disgusting, much less deadly sores of infected cows.

By 1800, Henrico County granted the first license for a smallpox inoculation clinic, at the estate of John Tabb near Richmond. During the 19th century, Richmond offered free vaccinations for its citizens. Doctors would receive dried cow scabs, along with instructions on how to administer them. This 1861 instruction sheet from Virginia’s vaccine agent, Dr. A.E. Peticolas, shows that the early vaccine was not administered by needle, but by rubbing the powdered scabs into a section of skin scratched raw by the doctor. Ouch!

Despite the pain and the ick factor, the vaccine was widely administered. After years of vigorous public health campaigns, smallpox was eliminated from the U.S. in 1949. It was eradicated from the world by 1980. It is the only disease to have been completely eliminated through vaccination, though hopefully not the last.