First introduced in 1798 by the English doctor Edward Jenner, smallpox vaccination generated a sensation in Europe and America in the first quarter of the nineteenth century. Vaccine became highly politicized in the American republic as enthusiasts debated how to implement the new preventive; some promoters argued that it was suitable for democratized use by self-reliant householders, while others insisted that the complexity of the procedure should limit its use to trained experts and "learned physicians." Disagreement centered on the place of knowledge in the republic and its accessibility to private citizens. The debate over proper vaccinators entered national politics in 1813 when Congress established the National Vaccine Institute (NVI) in response to the proposal of a Baltimore almshouse physician. Founded on the premise that it would supply any citizen---physician or not---with vaccine, the NVI represented an egalitarian view of science and medicine that held such knowledge both suitable and essential for virtuous republican citizens. This essay finds that from the introduction of vaccination to the United States in 1800-1822 through the destruction of the National Vaccine Institute in 1822, debates about proper vaccinators and medical knowledge played an important role in a broader debate about knowledge, social hierarchy, and the shape of the American republic.
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