By Farren Yero
On June 6, 1803, King Carlos IV of Spain signed a royal edict authorizing an expedition to transport the world’s first vaccine from the Old World to the New. He did so at the bequest of the cabildo (or municipal council) of Santa Fé de Bogotá, the capital of the viceroyalty of New Granada (present day Colombia, Ecuador, Panama, and Venezuela). For a year, a smallpox epidemic had ravaged the region, and local authorities implored the Crown to intercede. Renée Soulodre-La France suggests that the epidemic likely began in the port of Cartagena and traveled inland and by boat up the Magdalena River into the interior. As a result of the outbreak, approximately 2,800 people (an estimated 13% of the population) died in Santa Fé in 1802 alone. We do not have precise numbers for the duration of the epidemic—and thus cannot fully calculate the toll that it took—but accounts from the time suggest it was devastating. In Lima, the capital of the viceroyalty of Peru, Adam Warren recalls how the high morbidity rate compelled the city’s police lieutenant to abandon his regular duties for the sole task of managing records of death.
As a measure of control, health authorities implemented quarantines and, in some areas, variolation, but resources remained tight. Without adequate space to house and care for the quarantined and without funds to pay doctors, the cabildo of Santa Fé wrote to the king to request aid. The Council of the Indies, the governing body of the ultramar (or outer kingdoms of the empire), fielded the request, as well as a query that Spain might organize an expedition to deliver the smallpox vaccine recently published upon by the English doctor Edward Jenner. News of the vaccine had reached both Madrid and the Spanish Americas, and bureaucrats and doctors alike busily sought samples of this new technology. On the Iberian Peninsula, members of the Council of the Indies gathered over the course of several months to draw up plans and gauge the possibility of sending the vaccine from Cádiz to Cartagena.
To do so, the Council tapped local medical practitioners for all manner of advice: on the safety and efficacy of the vaccine itself; on best practices to send it and secure its viability; and most importantly, how to convince colonial subjects to accept this new medical intervention. No other figure so drastically shaped the Council’s response to these concerns than the Guatemalan physician Dr. José Flores. Living in Madrid at the time, Flores was well known for having orchestrated smallpox inoculation campaigns years earlier in the Audiencia of Guatemala. As such, the Council viewed him as an indispensable expert on both epidemic management and life in the Americas. The chief minister of the Council, Francisco Requena, sought his opinion on both. Flores responded enthusiastically detailing a lengthy proposal for an empire-wide campaign that convinced the Council to move forward and seek permission from the king.
First and foremost, the report responded to the issue of the vaccine itself, a fluid that dried out easily, and required a great deal of care and maintenance to ensure its viability. Flores recommended Spain send two ships from Cádiz, each preserving the vaccine through multiple methods: dried and sealed between glass slides and hosted live in the bodies of both livestock and human children. The remainder of Flores’s proposal addressed the actual public health practices to be administrated on the ground. As Martha Few argues, these suggestions were drawn from his own experience working across a wide range of environments and populations, including indigenous communities throughout Guatemala. Attentive to these differences, Flores made separate recommendations for urban and rural communities, but both underscored the importance of religiosity. When Flores orchestrated inoculation campaigns in the 1780s and 1790s, it was the clergy who helped communicate the concerns of both medical authorities and indigenous community members in the face of epidemic crisis. He stressed this point in his proposal, suggesting that priests be responsible for managing and even carrying out vaccinations in pueblos without a licensed physician of their own.
For Flores, however, the Church was not simply a source of labor. It was a critical site of public relations. Communicating to families the safety and even the sanctity of the vaccine was key to its successful adoption. With this in mind, the doctor suggested that priests might even consecrate vaccination as a religious rite of its own, one that could be carried out simultaneously with baptism. As Flores argued, “What more opportune means could there be than to accompany [vaccination] with religion so that the people can venerate it, appreciate it, desire it?” His plan recommended that records of vaccination be kept by local cofradias (religious confraternities), groups that would also fund the glass slides and other paraphernalia required to preserve the vaccine. Additionally, these items would be housed alongside consecrated oils and other sacred items in the parish sacristy. Flores even went so far as to advise the king to seek a papal bull to officially bless the procedure.
In the end, the Council did not adopt the full measures he recommended. No mention of baptism was made when Josef Antonio de Caballero, the Spanish secretary of state, relayed the news of the expedition to the Crown’s imperial representatives. And though a number of priests in the Spanish Americas did carry out vaccinations, there does not appear to be any evidence that clergy members did so at the baptismal font. Nevertheless, religion played an extraordinary role in the dissemination of the vaccine and the response to the 1802-1805 smallpox epidemic.
Officials accompanied the vaccine with sermons, pastoral letters, and other media intended to imbue it with both spiritual and political significance. Dressed in fine clothing, vaccinated children processed to the musical overtures of military bands and sung Te Deums, hosting the vaccine and advertising it to passersby through the streets.And when Dr. Josef de Salvany, the vice director of the royal expedition, finally made it to Santa Fé late in 1804, city leaders similarly welcomed his crew with a sermon given by the archbishop Juan Bautista Sacristán y Galiano. According to Salvany, locals there needed little persuasion, reporting that “the enthusiasm was great that reigned in favor of vaccination and the vaccine’s preservation.”
For centuries, priests were responsible for communicating new ideas, including Christianity, and they did so through this same form of drama and demonstration. In the early years of conquest and conversion, theater and pictorial catechisms translated concepts like transubstantiation and absolution across linguistic barriers. The Enlightenment did not render this pedagogy inert. Through moral plays and holy processions, visuality continued to characterize colonial education in the Spanish Empire, where vast communities remained illiterate. It was not all that strange then for authorities to adopt this same genre to impart a message of salvation and instill a sense of awe in the reparatory power of the vaccine.
At the turn of the century, responses to epidemic disease remained divergent, and certainly many rejected the vaccine, but opponents could rarely be found within the leadership of the Church. That priests advocated so fiercely for vaccination and for public health reform might come as a surprise given the haunting legacy of Black Legend impressions of the Spanish Empire, which was supposedly kept in the dark by robed clerics beating back the progressive march of science. Indeed, even as historians have documented the flurry of scientific and medical inquiry conducted in (and often for) the empire, there remains a curious teleology in which empiricism and scientific development prevailed over the course of the eighteenth century in spite of the Church, rather than at its behest.The history of the smallpox vaccine, and this particular epidemic, clarifies why this narrative is untenable. We see this especially in the case of Santa Fé, where one clergyman preached that when Christ sacrificed himself on the cross, he not only enabled man’s eternal salvation but freed him from the curse of smallpox. In other words, the introduction of the vaccine was preordained.
Authorities in Santa Fé celebrated this divine intervention with a sermon, one that marked the controlled use of vaccination and its role in ending the epidemic that had plagued the region for the last three years. Father Andrés Rosillo y Meruelo gave the sermon on February 24, 1805, and notably, he began with a quote taken from the prophet Isaiah: “The day destined for my judgment began the era of my redemption.” For Rosillo, if God had sent the epidemic that began in 1802, then he also sent the vaccine in restitution. The rector chose to portray this series of events as a cause for spiritual reformation, enjoining the congregation to consider anew their own redemption from what he called the “divine liberator.”
Rosillo reminded his audience that plagues had served for centuries as powerful displays of divine righteousness, a punishment for humanity’s sins. The vaccine promised a new age characterized by benevolence—but one that still demanded devotion and repentance. It was a sign of what progress might enable in an enlightened era otherwise corrupted by pride and profusion, excesses effected by invention for the sake of invention. In illustration, Rosillo intoned that the “Supreme Being,” ready to strike, “forgets, so to speak, that he is a God of vengeance, remembering that he is the Father of mercies. He stays his arm, already lifted to come down upon our heads, to repay the iniquity of man with extraordinary favor.” As Rosillo went on to instruct:
Yes, God, instead of oppressing us with sorrow, has shown himself to be liberal and benign. Who should refuse to know that He seeks to win our heart through sweetness, in order that we avoid punishment through voluntary reparation…And if one realizes that such a gift comes to us through the hands of our Prince, then no doubt, it a generous one he offers, an object to inspire us to obey him, serve him, and seek his advantages with all the love and zeal.
As a holy gift, the vaccine was to be received fearfully and willingly but only as much as it was a reminder to acolytes of their duties to the Church and Crown. According to the sermon, God chose Carlos IV as his vessel, one whose own “liberal and benign” reign reflected this new era of providence. In this way, vaccination was a call to order in line with the reformist spirit of Bourbon rule.
Similar overtures were made in the 1782 epidemic in New Granada, when the viceroy at the time, Antonio Caballero y Gongora, recommended that families follow prescribed public health interventions, noting that although disease was a sign of God’s “wrath and vengeance, deserved for our sins and public scandals,” He “also reveals Himself as a God of health and mercy.”
Others relied on a similar logic to persuade the public, including the French doctor Esteban Morel, who advocated so strongly for inoculation in New Spain that he claimed the choice to prevent disease would determine one’s afterlife. Advancing dangerously close to heresy, Morel insisted God would not punish those who diverted the seemingly natural order but would in fact celebrate it as part of one’s good deeds (or bienes de esta vida). Stipulating the terms of eternal salvation, the foreign doctor suggested that adults were responsible for inoculating their children, lest their life account (or cuenta) reflect poorly on them as parents and as Catholics. Rosillo did not go quite so far, but his sermon too obligated parents to vaccinate their children through claims to their salvation.
Authorities did not always agree on how far the ritualization of the vaccine should go, but many believed that lending it the air of ceremony was key to securing public participation. And as historian Paul Ramírez argues, they were not wrong. For as many families resisted or otherwise hid their children away, many more appear to have sought out the vaccine. Or at least they sought out the coins, cookies, and privileges offered by colonial authorities in exchange for their cooperation. In Mexico City, the viceregal capital of New Spain, for example, Father Juan José Guereña reported great success in the parish of San Miguel by providing a half real and a cookie for each child presented for vaccination.
This practice of gift-giving extended out of a well-established tradition in which authorities in the Spanish Empire earned the right to rule not through force but by “generous and conspicuous displays of largesse.” This was key to the patronage system that helped to hold the Spanish Empire together, and as Ramírez explains, the provision of modern medicine hewed closely to this framework. Thus, while religious demonstrations certainly drew crowds, and the numbers of those vaccinated increased according to their scale, parents likely complied for reasons less to do with authorities’ attempts to discipline them (and their souls) and more to do with their own curiosity about the vaccine, and of course, the pecuniary incentives offered in exchange.
Compliance with vaccination produced self-congratulatory reports from prelates and bureaucrats alike who confirmed the efficacy of their labor. Such records cast the masses as uneducated and impressionable, indicating that they knew not how to care for themselves or their families without a guiding hand. When parents took the Crown’s coin, it further served to vindicate elites’ paternalistic approach to health intervention. To this effect, one surgeon reported that the vaccine survived amongst the poor “only by the lively expressions of their parish priests…because it is thought that they are being tricked.”
Yet, at the same time, the royal treasury expended hundreds of thousands of pesos to fund the illumination of churches, singers and musicians, and fireworks, rivaling, as Ramírez suggests, the most expensive festivals held on feast days like Corpus Christi. Financial ledgers reveal these careful expenditures, but less accounted for are the small, informal gifts that parents had come to expect along the way. The overtures of both, designed to secure parents’ consent, suggest just how dependent authorities were on these supposedly ignorant masses to sustain and propagate the vaccine, and with it, the Crown’s own authority to govern through health. As in the earliest years of conquest and colonization, religion remained the medium through which subjects and rulers negotiated their loyalties to one another.
Vaccination and its enforcement, as Nadja Durbach argues, is always a political act, and in each case, “who wielded the needle or the lancet and whose body was marked governed how vaccination was experienced and the meaning attached to it.” In 1805, the vaccine marked a shift not only in the administration of public health but arguably in the very way that colonialism came to operate at the close of the century. In the wake of the Haitian Revolution, the Atlantic World experienced a cultural moment in which political authority became deeply contested, compelling imperial rulers to adapt if they were to maintain their sovereignty. The vaccine—and the language of Enlightened benevolence and salvation that underwrote its introduction—reflects a reconfiguration of the longstanding paternalist approach that characterized Spanish rule. The Church was essential to this process and would remain at the center of debates over public health, scientific education, and even reproductive medicine throughout the nineteenth century.
Thus, although Archbishops, priests, and even doctors no longer promulgated eschatological visions of smallpox as the consequence of man’s sins, in this pivotal moment, their articulation of public health still served to uphold both Spain’s divine rule and its attendant structures of power, helping weave healthcare into the fractional freedoms accorded to and claimed by subjects and citizens in the Age of Revolutions.
Farren Yero is a Postdoctoral Associate in the Department of Gender, Sexuality, and Feminist Studies at Duke University, a 2022 CHCI-ACLS Fellow at the University of Edinburgh, Institute for Advanced Studies in the Humanities, and a 2022-2023 NEH postdoctoral fellow at the Omohundro Institute of Early American History and Culture. She is a historian of Latin America and the Caribbean, specializing in gender studies and the history of race, health, and medicine. Her writing has appeared in The Recipes Project, The Panorama, Age of Revolutions, and Epidemic Urbanism: Contagious Diseases in Global Cities, eds. Mohammad Gharipour and Caitlin DeClercq (Intellect, 2021). Her research has been supported by the ACLS, Fulbright-Hays, the Andrew W. Mellon Foundation, the John Carter Brown Library, and the Newberry Library. You can find her on Twitter at @feyero.
Title Image: José Maria Montes de Oca, Celebra Regozijada Mexico, la Beatificacion de su Esclarecido hijo el Bienaventurado Felipe de Jesus (Mexico City, 1801). Courtesy of the John Carter Brown Library.
Few, Martha. For All of Humanity Mesoamerican and Colonial Medicine in Enlightenment Guatemala. Tucson: The University of Arizona Press, 2015.
Larkin, Brian. The Very Nature of God: Baroque Catholicism and Religious Reform in Bourbon Mexico City. Albuquerque: University of New Mexico Press, 2010.
Jaffary, Nora. Reproduction and Its Discontents in Mexico: Childbirth and Contraception from 1750 to 1905. Chapel Hill: University of North Carolina Press, 2017.
O’Brien, Elizabeth. “‘If they are useful, why expel them?’ Las Hermanas de la Caridad and Religious Medical Authority in Mexico City Hospitals, 1861-1874.” Mexican Studies/Estudios Mexicanos 33.3 (2017): 417-442.
Ramírez, Paul F. Enlightened Immunity: Mexico’s Experiments with Disease Prevention in the Age of Reason, Stanford: Stanford University Press, 2019.
Ramos, Christina. Bedlam in the New World: a Mexican Madhouse in the Age of Enlightenment. Chapel Hill: University of North Carolina Press, 2022.
Rigau-Perez, Jose G. “The Introduction of Smallpox Vaccine in 1803 and the Adoption of Immunization as a Government Function in Puerto Rico.” The Hispanic American Historical Review 69, no. 3 (August 1989): 393-423.
Warren, Adam. Medicine and Politics in Colonial Peru Population Growth and the Bourbon Reforms. Pittsburgh: University of Pittsburgh Press, 2010.
Voekel, Pamela. Alone Before God: The Religious Origins of Modernity in Mexico. Durham: Duke University Press, 2002.
 Archivo General de Indias (AGI), Indiferente 1558a, Antonio Caballero to Antonio Gimbernat, Aranjuez, June 6, 1803, f. 2-3. For more on the organization of the expedition, see: Fernández del Castillo, Los viajes de Don Francisco Xavier de Balmis(Mexico: Galas de Mexico, 1960), 67-77; See also: Michael M. Smith, “The ‘Real Expedición Marítima de La Vacuna’ in New Spain and Guatemala,” Transactions of the American Philosophical Society, New Series, 64, no. 1 (January 1, 1974): 1-74.
 AGI, Indiferente 1558a, Ayuntamiento de Santa Fe de Bogotá to Caballero, June 19, 1802.
 Renée Soulodre-La France, “Sailing Through the Sacraments: Ethnic and Cultural Geographies of a Port and Its Churches-Cartagena de Indias,” Slavery & Abolition 36, no. 3 (July 3, 2015): 465. This was the case with the 1782 smallpox epidemic, to which accounts from the time frequently make comparison. For more on both epidemics, see: Marcelo Frias, Enfermedad y Sociedad en la Crisis Colonial del Antiguo Régimen: Nueva Granada en el Tránsito del Siglo XVIII al XIX (Madrid: Consejo Superior de Investigaciones Científicas, 1992) and Renán Silva, Las Epidemias de Viruela de 1782 y 1802 en el Virreinato de Nueva Granada Contribución a un anáisis histórico de los procesos de apropiación de modelos culturales (Medellín: La Carreta Editores. E.U. 2007).
 This figure comes from Edwin Lopez-Rivera, “Living Conditions in Bogotá at the Beginning of the Nineteenth Century: Smallpox Epidemics and the Colonial Economy,” Congreso XX, Asociación de Colombianistas (2017). His numbers are drawn from Julian Vargas, La sociedad de Santa Fe Colonial (Bogota: Centro de Investigación y Educación Popular CINEP, 1990), Silva, Las Epidemias de Viruela de 1782 y 1802 (2007), and Frias, Enfermedad y Sociedad (1992)
 Adam Warren, Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms (Pittsburgh: University of Pittsburgh Press, 2010), 81.
 Edward Jenner, An Inquiry into the Causes and Effects of the Variolae Vaccinae: A Disease Discovered in Some of the Western Counties of England, Particularly Gloucestershire, and Known by the Name of the Cow Pox (London: Sampson Low, 1798).
 Although Flores was the architect of the royal philanthropic expedition, he himself did not participate in its execution. It is unclear if the council ever offered him a place amongst the crew. He remained in Spain until his death in 1824. For more on Flores and his role in the expedition of the vaccine, see: Martha Few, “Circulating Smallpox Knowledge: Guatemalan Doctors, Maya Indians and Designing Spain’s Smallpox Vaccination Expedition, 1780-1803,” British Journal for the History of Science 43, no. 159 Pt 4 (December 2010): 519–37.
 AGI, Indiferente General 1558a. José Flores to the Council of the Indies, February 28, 1803.
 The king signed off on a version of this plan on July 28, one that called for a crew of a single ship, which set sail from La Coruña, Spain in November later that year. Led by the director, Dr. Francisco Xavier de Balmis, the expedition made stops in the Canary Islands, Puerto Rico, Caracas, and Cuba, before one half of the crew sailed on to Cuba, Mexico, the Philippines, Macao, and St. Helena, before returning to Madrid via Lisbon. From Caracas, the other half made their way south into the Andes with the vaccine supply that the Santa Fé cabildo requested over two years before. For more on the expedition, see: Gonzalo Díaz de Yraola, La vuelta al mundo de la expedición de la vacuna (Sevilla, 1948); José G. Rigau-Pérez, “The Introduction of Smallpox Vaccine in 1803 and the Adoption of Immunization as a Government Function in Puerto Rico,” The Hispanic American Historical Review 69, no. 3 (1989): 393–423; Susana María Ramírez Martín, La salud del Imperio: la Real Expedición Filantrópica de la Vacuna (Madrid: Fundación Jorge Juan, 2002); Catherine Mark, and José G. Rigau-Pérez. “The World’s First Immunization Campaign: The Spanish Smallpox Vaccine Expedition, 1803–1813,” Bulletin of the History of Medicine 83, no. 1 (2009): 63–94. For the South American portion of the expedition, see: Warren, Medicine and Politics in Colonial Peru (2010) and Aníbal Ruíz Moreno, Introducción de la vacuna en America, expedición de Balmis (Buenos Aires, Universidad de Buenos Aires, 1947).
 Warren similarly notes that it was Lima’s priests (and not its doctors) who most fiercely advocated for inoculation in the 1770s. Medicine and Politics in Colonial Peru, 83.
 AGI, Indiferente General 1558a. José Flores to the Council of the Indies, February 28, 1803, f. 311.
 AGI, Indiferente General 1558a. San Ildefonso. Caballero. September 1, 1803.
 Children had long performed character roles in holy festivals and celebrations—they were important for the effect of these displays—but now, children took on even greater significance, as they were not only representing vaccination but actually doing the work of producing it itself.
 Quoted in Warren, Medicine and Politics, 98.
 Louise M. Burkhart, The Slippery Earth: Nahua-Christian Moral Dialogue in Sixteenth-Century Mexico (Tucson: University of Arizona Press, 1989); Patricia Seed, Ceremonies of Possession in Europe’s Conquest of the New World, 1492-1640 (Cambridge: Cambridge University Press, 2010); Holy Wednesday: a Nahua Drama from Early Colonial Mexico(Philadelphia: University of Pennsylvania Press, 2010); Elizabeth Hill Boone, Louise M. Burkhart, and David Tavárez, Painted Words: Nahua Catholicism, Politics, and Memory in the Atzaqualco Pictorial Catechism (Washington, D.C.: Dumbarton Oaks Research Library and Collection, 2017).
 Daniela Bleichmar, Visible Empire: Botanical Expeditions and Visual Culture in the Hispanic Enlightenment (Chicago; London: The University of Chicago Press, 2012). In the case of vaccination, these representations were not about cataloging and representing the natural world but about a lived experience of nature, translated through visual culture.
 The Spanish Black Legend consisted of anti-Spanish and anti-Catholic claims made by Spain’s European rivals to undermine its influence over global affairs. These biases notably shaped the work of historians and chroniclers writing into the nineteenth and twentieth centuries. For more, see: Margaret Greer, Walter Mignolo, and Maureen Quilligan, Re-reading the Black Legend: Discourses of Religious and Racial Difference in the Renaissance Empires. Chicago: University of Chicago Press, 2007); Charles Gibson, The Colonial Period in Latin American History (Washington D.C: American Historical Association. Service Center for Teachers of History, 1970).
 For more on the Enlightenment and the Church, see especially: Pamela Voekel, Alone before God: The Religious Origins of Modernity in Mexico (Durham: Duke University Press, 2002). Her study of nineteenth-century Catholicism and liberal reform demonstrates that although liberals sought to secularize the state, they did so while operating within the social, political, and cultural milieu of Catholic piety. After independence, vaccination campaigns would notably continue pivot around the church, as a site of both influence and even vaccine distribution; public notices throughout the first half of the century directed parents to bring their children to their parish to receive and harvest the vaccine, a site likely more inviting than police stations and other state institutions that the ministries of health would later suggest.
 Andrés Rosillo y Meruelo, Sermon…fue celebrada para manifestar el reconocimiemto de este nuevo reyno a Dios, y al rey por este beneficio (En la Imprenta Real: por D. Bruno Espinosa de los Monteros. Calle de San Felipe, 1805), 1. The verse comes from Isaiah. Cap. 63, Verse 4, in Latin, as: “Dies ultionis in cord meo annus redemption’s mea venit.”
 Ibid., 3.
 Ibid., 6-7.
 The Bourbon Reforms refers to a set of centralizing policies on the part of the Spanish Bourbon Crown, beginning with King Philip V, that channeled Enlightenment-era conceptions of public health, science, and finance to try and limit the Church’s influence and to consolidate monarchal power over transatlantic trade. For more, see: Kenneth J. Andrien, “The Bourbon Reforms,” Oxford Bibliographies Latin American Studies (Last Modified May 24, 2018).
 “Edicto del Virrey Antonio Caballero y Gongora, Santa Fe, 20 de Noviembre de 1782” cited in Frias, Enfermedad y Sociedad, 240–241.
 Archivo Histórico del Distrito Federal (AHDF), Ayuntamiento. Policía: Salubridad. Vol. 3678, Exp. 2, 1780. “Disertación presentada al ayuntamiento por el Doctor Esteban Morel sobre la inoculación de la vacuna.” For more on Morel, see: Liliana Schifter Aceves, Medicina, minería e inquisición en la Nueva España: Esteban Morel, 1744-1795 (México: Universidad Autónoma Metropolitana, Unidad Xochimilco, 2002) and his fate with the Inquisition, see: AGN, Inquisition, Vol. 1379, Exp. 11, 1795. “Relacion de causa seguida por el Santo Oficio contra el doctor Don Esteban Morel.”
 Paul F. Ramírez, Enlightened Immunity: Mexico’s Experiments with Disease Prevention in the Age of Reason (Stanford: Stanford University Press, 2019).
 Archivo General de la Nación (AGN), Epidemias, Vol. 10, Exp. 7, f. 338–341. José Guereña to Iturrigaray, Mexico City, August 26, 1806. As a recognized authority on the subject, Guereña was asked to advise the central vaccine committee on best practices. Above all else he recommended the gifting of these coins and cookies, suggesting that alcaldes (local magistrates) dispense them each time they harvested children from their respective municipalities. This incentive, he judged, was usually enough to wear down the “most reluctant of mothers,” suggesting the extent to which women dictated the choice of whether or not their children would be vaccinated. This set of relations appears to be a common practice throughout New Spain and other regions within the Spanish Empire.
 Ramírez, Enlightened Immunity, 174.
 AGN, Epidemias Vol. 10, Exp. 12, Antonio Serrano to Iturrigaray, Mexico City, November 26, 1804, f. 454–455.
 Ramírez, Enlightened Immunity, 158.
 Nadja Durbach, Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907 (Durham, NC: Duke University Press, 2005), 5.
 After independence, Mexico, for example, remained a Catholic country, with the 1824 Constitution proclaiming Catholicism as the state religion. Indeed, bureaucrats regularly performed their Christianity as a form of nationalism. With independence, official correspondence dropped salutations wishing the king many years of good health and instead adopted the phrase “For God and Liberty.” Thus while liberals sought to secularize the state, they did so while operating within the social, political, and cultural milieu of Catholic piety, a point that Pamela Voekel makes in her study of nineteenth-century Catholicism and liberal reform (Pamela Voekel, Alone before God: The Religious Origins of Modernity in Mexico (Durham: Duke University Press, 2002). Vaccination campaigns would continue pivot around the church, as a site of both influence and even vaccine distribution; public notices throughout the first half of the century directed parents to bring their children to their parish to receive and harvest the vaccine, a site likely more inviting than police stations and other state institutions that the Consejo Superior de Salubridad would later suggest (AHDF, policía salubridad, Vol. 3679, exp. 55, f. 2-3. 1826.)
 Fractional freedoms is a term used by Michelle McKinley to suggest the limited extent to which enslaved and emancipated peoples could mobilize the law and liberation to acquire freedoms for themselves and their families. See: Michelle McKinley, Fractional Freedoms: Slavery, Intimacy, and Legal Mobilization in Colonial Lima,1600-1700 (New York, NY: Cambridge University Press, 2016).