History of Mandatory Vaccination
Immunization laws in the US are not federal, but state mandates. The authority of U.S. states to promulgate regulations which protect the public health and safety is well established, having historical roots in health regulations created in the colonial states during the 18th century. A seminal Supreme Court decision in 1905, Jacobsen v. Massachusetts, 197 U.S. 11 (1905), affirmed the authority of state legislatures to assign "police powers" to health officials to enact quarantines and enforce mandatory vaccination laws to prevent epidemics.
Although the historic and legal precedent for state authority to enact and enforce mandatory vaccination laws is clear, it is not without legal limitations and ethical imperatives.
State Public Health Laws for 18th Century Epidemics
State public health laws in the U.S. can be traced back to the 18th and 19th centuries when unpredictable epidemics of highly contagious, dangerous diseases such as yellow fever, typhoid fever and smallpox would sweep through crowded, unsanitary port cities after diseased immigrants would disembark from boats and infect the community. Eventually volunteer citizen committees formed to quarantine the boats entering the harbors for weeks until those disembarking were certified "disease-free."
At the turn of the century, after doctors had taken over these volunteer citizen committees and funding from taxes supported the beginnings of a state and national public health infrastructure, the first state vaccination laws were enacted by legislatures at the urging of physician public health officials. Soon the idea of quarantining those with infection during epidemics extended to those who were not vaccinated, such as excluding unvaccinated children from school during smallpox epidemics.
1905 Supreme Court
Speaks
In 1905, a man named Jacobsen and his son sued the state of Massachusetts for requiring them to get a second smallpox vaccination or pay a $55 fine. Jacobsen refused to get re-vaccinated or pay the fine, claiming he and his son had had a bad reaction to a previous smallpox vaccination and were afraid they would be injured or die by a second one. Jacobsen maintained that forcing him to be revaccinated was "an assault upon his person" and violated his Constitutional rights.
The Supreme Court rejected the evidence Jacobsen presented to show that the smallpox vaccination can cause injury and death and to demonstrate that doctors cannot distinguish between those who will be harmed and those who won't be harmed by the vaccination. The Court concluded "The matured opinions of medical men everywhere, and the experience of mankind, as all must know, negate the suggestion that it is not possible in any case to determine whether vaccination is safe."