Mandatory Vaccination in the United States: A Past and Present Examination of Jacobson v Massachusetts

There is no doubt that vaccination has been one of the greatest successes of public health programs in the 20th century. Vaccinations have eradicated naturally occurring smallpox, and have substantially reduced morbidity and mortality from infectious diseases that previously ravaged the population, such as polio and measles. Despite the successes, there has been a history of “anti-vaccinationists” in the U.S., who among other challenges, argued compulsory vaccination was an infringement upon personal liberty and their right to choice (1, 2). In fact, it took a Supreme Court decision to ultimately assert whether a state mandating vaccination infringed upon the U.S. Constitution.

Compulsory vaccination in the U.S. was established in the federal Supreme Court case Jacobson v. Massachusetts, which ruled that the common good allowed a state to require vaccination (3). This 1905 landmark decision held that the common good – defined as safety and health – could override personal liberty in the matter of vaccination laws (3).

Henning Jacobson, a resident of Cambridge, Massachusetts, refused smallpox vaccination required by a recently enacted regulation of the city, and was assessed a $5 fine (roughly $125 in today’s currency). Mr. Jacobson refused on the grounds the vaccination caused harm and violated his personal liberties granted by the U.S. Constitution, citing the Preamble and the 14th amendment; namely, Section 1 of the 14th amendment, which states “No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law” (4).

The case progressed from the local court to the state supr...

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..., will continue to be a “battle of ideas” not unlike the battle of ideas over a hundred years ago (11). Moving forward, the best path may simply be to present the facts in a clear objective fashion, enable legislation to remove barriers to vaccination, and continue to let parents and adolescents decide whether to receive vaccination.

Works Cited

1. Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ. 2002 Aug 24;325(7361):430-2.

2. Salmon DA, Teret SP, MacIntyre CR, Salisbury D, Burgess MA, Halsey NA. Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future. Lancet. 2006 Feb 4;367(9508):436-42.

3. Jacobson v. Massachusetts, 197 U.S. 11 (1905).

4. U.S. CONST. amend. XIV, § 1.

5. Gostin LO. Jacobson v Massachusetts at 100 years: police power and civil liberties in tension. Am J Public Health. 2005 Apr;95(4):576-81.