Mistrust in medicine: The rise and fall of America's first vaccine institute

Tess Lanzarotta*, Marco A. Ramos

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


In 1813, the American government passed An Act to Encourage Vaccination, the first federal endorsement of a medical practice in American history. The law tasked a federal agent with maintaining a supply of the smallpox vaccine and distributing it nationwide. James Smith, a well-respected physician and proponent of vaccination, was appointed as vaccine agent. Smith was skeptical of claims that only well-trained physicians should be allowed to perform vaccination; he felt it was a simple procedure that should be available to all American citizens. In 1822, he made a tragic error that caused several deaths and left him vulnerable to criticism from political opponents and his medical peers. This ended Smith's professional career and led to the repeal of the act itself. In this article, we use the rise and fall of James Smith to provide a historical perspective on contemporary debates surrounding delayed vaccination schedules. We explain how physicians-in the 19th century and today-have worked to build public trust in vaccination in an American culture suspicious of medical expertise.

Original languageEnglish (US)
Pages (from-to)741-747
Number of pages7
JournalAmerican journal of public health
Issue number6
StatePublished - Jun 2018
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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