In the words of Jefferson's friend Dr. Benjamin Waterhouse, smallpox was the "devouring monster"—a horrific disease that covered its victims with painful, suppurating sores and left its survivors with ugly, indelible scars. Brought to North America by European voyagers from the time of Columbus, it decimated native populations. Death rates in epidemics in American cities in the eighteenth century were as high as thirty percent.
A method of prevention—a risky alternative to living in dread of the disease—was available. Inoculation involved the deliberate introduction of smallpox to create future immunity. In other words, it caused an actual case of the disease, usually a light one, although a small percentage of patients died. Inoculation had been practiced in Asia and Africa for hundreds of years, but became known in Europe and America only in the early eighteenth century. After Rev. Cotton Mather learned of it from an enslaved African, Onesimus, "who is a pretty intelligent fellow," the operation was introduced to the colonies during a Boston smallpox epidemic in 1721.
This frightening procedure made little headway in Virginia, where public fear and restrictive laws virtually eliminated it for many years. In 1766, Jefferson had to go all the way to Philadelphia to have himself inoculated. Two years later, a mob burned down the house of a Norfolk doctor who had inoculated some local citizens.
Smallpox reached the enslaved people on Jefferson's plantations during the Revolution. In 1781 five slaves at Elkhill in Goochland County died after catching the disease from invading British soldiers. Fifteen of twenty-three men, women, and children who ran away with the British army later died of smallpox or "camp fever" in the Tidewater encampments.
Jefferson was a lifelong champion of the available methods of fighting smallpox. As a lawyer he defended the inoculating doctor in Norfolk. He took measures to have his children and enslaved domestic servants inoculated. In the 1770s and 1780s, Robert, Martin, James, and Sally Hemings endured the long and dangerous process. In 1797 Jefferson's daughter Martha Randolph expressed a mother's "anxiety" when her children were taken to Richmond for inoculation: "My eyes fill with tears to think how soon we shall part and perhaps for ever."
Considerable courage was needed to undergo as well as advocate inoculation, until a far better remedy arrived in the United States in 1801. English physician Edward Jenner developed a safer method of vaccination with cowpox, a mild relative of smallpox, and Dr. Waterhouse, the method's main champion in this country, provided Jefferson with some of Jenner's "vaccine matter." At the President's House in Washington on May 29, Jefferson selected an enslaved kitchen apprentice for the first trial of the new procedure. The vaccination of fourteen-year-old Ursula (later Ursula Hughes), daughter of Bagwell and Minerva Granger, did not "take." In further experiments later that summer at Monticello, butler Burwell Colbert and blacksmith Joseph Fossett were the first to be successfully vaccinated.
Jefferson used material from the arms of Colbert and Fossett in further vaccinations, and in the next six weeks his sister, niece, and granddaughters, an overseer and a brickmason, and almost fifty enslaved men, women, and children were made safe from smallpox forever. Jefferson sent vaccine matter on to Washington, from where—by further vaccinations—it traveled to Philadelphia and beyond. Monticello's African Americans thus participated in protecting great numbers of their countrymen from the scourge of smallpox.