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“All Sorts of People”

The Beginning of Vaccination in America


Karen M. Aguirre
Department of Biology
Coastal Carolina University


This historical case study is based upon events surrounding the deadly 1721 smallpox epidemic in Boston. It recounts the story of Cotton Mather, his slave Onesimus, and the physician Zabdiel Boylston. Urged by Mather, Dr. Boylston inoculated Bostonians against smallpox and then compared the death rate of those exposed to this early form of vaccination to the death rate of those who did not receive the treatment. The story is especially interesting not only because Boylston's work was arguably the very first clinical trial in the Americas and foreshadows how candidate vaccines are developed and tested today, but also because it involves the little-known contribution of an African slave, Onesimus, to the American story. The case illustrates how progress in science in the United States involved contributions from the wisdom and cultural practices of diverse places and from "all sorts of people." The case is suitable for high school AP biology classes, college-level biology courses for non-majors, or as material to supplement early lectures in an undergraduate immunology, microbiology, or epidemiology course.

  • Elaborate the three criteria for a new vaccine, i.e., it must be safe, effective, and practical (feasible cost associated with delivery).
  • Build numeracy by generating and analyzing quantitative material presented in tables and graphs.
  • Translate a textual narrative about immunity into a diagram or flow-chart illustrating the step-by-step course of infection.
  • Work independently, but cooperatively, to choose and research a topic related to diversity and science, practicing research techniques, critical reading, fact selection, organization of a coherent paper, giving and responding to constructive criticism, and final presentation of a polished project.
Keywords: Onesimus; smallpox vaccination; immunological memory; clinical trials; diversity; Boston; 1721; Boylston; Mather; inoculation; cowpox
Topical Area: History of science, Diversity in science, Social justice issues
Educational Level: High school, Undergraduate lower division, Undergraduate upper division
Formats: PDF
Type/Method: Directed, Discussion
Language: English
Subject Headings: Biology (General)   Medicine (General)   Microbiology   Public Health   Science (General)  
Date Posted: 10/11/2019
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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