11. Stimulated by a severe epidemic, variolation was first employed in North America in 1721. 12. But people undergoing variolation felt well enough to be out and about _ while fully contagious. 13. To create immunity, Americans turned to variolation , in which smallpox was inserted through the skin. 14. A very early form of vaccination known as variolation was developed several thousand years ago in China. 15. The patriarch Robert Sutton was a surgeon from Suffolk who began experimenting with the practice of variolation . 16. The simplest debate argued that variolation was ungodly because it was not mentioned specifically in the Bible. 17. Its implementation at the time was impractical for logistical reasons and the risk that variolation would spread smallpox. 18. The term " variolation " was then used from the 19th century to avoid confusion with vaccination. 19. The use of variolation soon began to decline as the smallpox vaccine became widely used and its benefits appreciated. 20. The variolation available to the rich ended up making things worse for those who could not afford to buy immunity.