Vaccinating Mexico: Smallpox, Public Health, and the Metamorphosis of a Welfare State

It has been observed that Western states in the nineteenth century prioritized warfare and industry over the welfare of citizens. The experiences of Latin American nations as they emerged from Spanish rule seem to confirm this observation. Throughout the region, states struggled to finance wars, protect territorial boundaries, and promote nascent industries, and dedicated relatively few resources to matters of public health. Nevertheless, when it came to infectious diseases such as cholera or smallpox (and those of a moral or psychological nature that were so construed), states and their citizens occasionally did take an active and even proactive interest and role.

This paper draws on the history of epidemics and preventive medicine in Mexico as a proxy for questions about nation-building processes, public welfare programs, and shifts in medical and religious authority. Specifically, it seeks to correct the picture of vaccination against smallpox in Mexico, in which immunization practices are extrapolated from the Spanish vaccination expedition that passed through the region in 1804. Preventive campaigns in nineteenth-century Mexico were neither continuous with this episode nor uniform but instead had to be revived and renewed repeatedly, in local efforts that lasted for decades.

How were these successes in immunization achieved? More broadly, when did states prioritize health? And when they did not, why did communities and local institutions step in to fill the gap? While clarifying the Mexican case, this paper offers a comparative view, in service of a clearer picture of the causes, scope, and durability of investments in disease prevention and human welfare in the nineteenth century.