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Every spring since the arrival of European fishermen to dry their cod on the rocky shores of New England, the smallpox epidemic has afflicted Native Americans and settlers alike.

When the pilgrims landed in 1620, they found fields already planted and cities empty. The Wampanoag had been decimated by smallpox after John Smith's reconnaissance north of Jamestown.

Every time a dynastic war broke out in Europe, a tsunami of smallpox devastated the English settlements. One in ten Bostonians died of smallpox when ships carrying soldiers and sailors arrived from England in 1689 to fight the French on the New England border in King William's War. Three decades later, one in twelve Bostonians died when Queen Anne's War imported a new smallpox shipment. The survivors began moving inland to escape the contagion.

The vaccination was met with scepticism.

After reading a report on mass vaccination in Turkey in the Transactions of the British Royal Society, the influential Puritan preacher Increment Mather urged his neighbor, Dr. Zabdiel Boylston to conduct an experiment. Impressed by the possibility of reducing mortality by vaccinating healthy people with live smallpox, Boylston vaccinated his own son, among others.

Boston split into two noisy camps. Deliberately spreading smallpox through vaccination seemed criminally stupid to most when nearly every home waved the quarantine flag. They saw no benefit in allowing a doctor to cut a vein and fill the incision with pus from a sick victim.

Unfortunately, Boylston could not isolate his patients during the incubation period, and smallpox spread through contact with them. Mather and Boylston angered most of the Puritan clergy in New England, who considered it a great sin to interfere with God's will by attempting to prevent death.

As the controversy spread, printers competed in outrage. Benjamin Franklin's older brother James' New England Courant berated Mather and Boylston and incited a superstitious public to revolt. Ironically, Benjamin's only legitimate child died a dozen years later at age 4 because Franklin refused to vaccinate him during an outbreak in Philadelphia. Public opposition to Mather became so great that someone threw a bomb through his study window.

As colony after colony banned vaccination, the search for it became a crime. When a man in Connecticut held out his arm to a doctor so he could insert a needle by threading an infected thread under his skin, he was arrested.

The Washington Pandemic

When Thomas Jefferson's favorite sister died of smallpox 10 days after their marriage, he traveled from Charlottesville to Philadelphia in a buggy for an illegal vaccination.

When two people died near Norfolk after vaccinated patients were released early from quarantine, clashes between pro-vaccination and anti-vaccination factions sparked riots. Two doctors who administered the vaccinations were prosecuted; one was driven out of town and his house burned down.

General Washington was selected by the Second Continental Congress to command the New England troops besieging Boston, and when General Washington arrived in Cambridge he found smallpox raging among soldiers and civilians.

George Washington contracted smallpox during a trip to Bermuda when he was 19. He later wrote that only his strong constitution saved him from death.

He immediately ordered all soldiers to be vaccinated. By quarantining his troops on one side of a pond and pinning civilians on the other, he was able to contain the outbreak.

The army he sent north to conquer Quebec fared even worse. Half of the 10,000 unvaccinated reinforcements from Massachusetts and Connecticut died of smallpox as the defeated US Army staggered south.

When the Continental Army wintered in Morristown in 1776, Washington decided that he had to vaccinate his entire army or the revolution would collapse.

"Smallpox is so advanced in all sectors that there is no way I can prevent it from spreading throughout the army...I have decided to vaccinate all the troops here," he wrote to John Hancock, President of Congress. Then, without waiting for Congressional approval, he ordered his medical staff to "vaccinate the troops as soon as they arrive."

In the winter of 1777, Washington secretly ordered the 4,000 men of Valley Forge to be vaccinated. He divided them into small groups to quarantine for a month while Martha Washington and other officers' wives tended to them. Ninety-five per cent survived.

At no point did the British have a better chance of crushing the revolution, but they did celebrate in Philadelphia as Washington's vaccinated army practised and prepared to pursue the British army into New York City in the spring.