The Real Expedición Filantrópica de la Vacuna was, together with reforms in commerce, administration, and education, one of the most ambitious projects of the Spanish Enlightenment. Setting off from Spain in 1803, the expedition passed through the Canary Islands, Puerto Rico, and Cuba before arriving in New Spain in 1804. A branch of the expedition reached South America. Marking as it did a successful transition in medical theories and disease management policies, the expedition—especially the doctors and bureaucrats who made the smallpox vaccine available to children around the Spanish empire—has received a good deal of scholarly attention. Paul Ramírez presents a novel picture of the inoculation campaign in New Spain by shifting the focus to include the laypeople who received the vaccine—parents, indigenous villagers, barbers, and healers, whose active participation shaped the ways the campaign operated “on the ground.” Drawing on an...

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