During the American Revolution, smallpox was a more terrifying enemy than the British army. The highly contagious virus swept through civilian populations and military camps, killing indiscriminately. According to the historical nonprofit American Battlefield Trust, smallpox during the war “proved fatal to one-third of those who contracted the disease” (“Washington Inoculates an Army.” American Battlefield Trust), a figure that rose among dense, unhygienic military encampments. This context illuminates the terror Abigail feels in A Founding Mother and the immense risk she undertakes in 1776 by choosing to inoculate herself and her children.

The novel details the family’s ordeal as they convalesce in a crowded Boston house, hoping the procedure “had taken” (83) without proving fatal. This procedure, known as variolation, was the precursor to vaccination and involved intentionally infecting a healthy person with live smallpox matter taken from a pustule. Though it produced a milder infection and lifelong immunity, the practice was dangerous, with a mortality rate of approximately 2%. Understanding this desperate calculus—a near-certain but small risk of death versus a potential future encounter with a much deadlier version of the disease—frames Abigail’s decision not as an act of deep courage. Her personal gamble foreshadowed a key military decision; in 1777, General George Washington mandated the variolation of the entire Continental Army, a move credited with preventing its collapse and ensuring the continuation of the war effort.