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,
1837 Great Plains smallpox epidemic experienced a major smallpox epidemic in 1780-81 which severely reduced their numbers down to less than a few thousand. Many other bands along the Missouri river suffered smallpox epidemics during 1801-02 and 1831. Sporadic efforts were made to promote vaccination among the Indigenous peoples since the turn of the nineteenth century. Later, the Indian Removal Act the U.S. Congress took its first step in 1832 to generate public support for vaccination of the Native Americans. But shortly after passage of this congressional act to extend vaccinations to Indians, Secretary Cass stated that no effort would be made "under any circumstances"