Mozart and smallpox the imperial family were successful, and led to greater public acceptance for the procedure. Smallpox struck the Mozart family again in the next generation: Nannerl's eldest son Leopold and two of her stepchildren caught the disease during an outbreak in the Salzburg area in 1787. All three children survived. In 1796, the discovery of vaccination—the use of the related cowpox virus to immunize against smallpox—by Edward Jenner revolutionized the ability of medicine to deal with smallpox. Vaccination reached Vienna around 1800, when yet another local epidemic created impetus for its adoption. One of the doctors trained in the Vienna campaign,
Vaccination infected adults and over 80% of infected children. When smallpox was finally eradicated in 1979, it had already killed an estimated 300–500 million people in the 20th century. In common speech, "vaccination" and "immunization" have a similar meaning. This distinguishes it from inoculation, which uses unweakened live pathogens, although in common usage either can refer to an immunization. Vaccination efforts have been met with some controversy on scientific, ethical, political, medical safety, and religious grounds. In rare cases, vaccinations can injure people. In the United States, people may receive compensation for those injuries under the National Vaccine Injury Compensation Program.