A 1905 SCOTUS case explains why COVID-19 vaccine laws are permissible today

A Post by: Ellaheh Gohari

December 28, 2022

The COVID-19 pandemic has garnered new scrutiny on compulsory vaccination laws, but — contrary to what some people might claim — the idea of requiring vaccines is not new. In fact, over a century ago, the Supreme Court was tasked with considering this very question when, after a 1902 outbreak of smallpox, the Massachusetts state legislature passed a law that allowed cities or municipalities to enforce a mandatory smallpox vaccine. Failure to comply would result in a $5 fine, equivalent to $173 today.

Though the smallpox vaccine had been around for over a century by that point — it was introduced by Edward Jenner in 1796 according to the World Health Organization — vaccine hesitation still abounded. Henning Jacobson, a pastor living in Cambridge, Massachusetts, was one such hesitator. Originally from Sweden, where attempts to eradicate smallpox were successful largely because of their mandatory vaccination laws, Jacobson had already experienced forced vaccination before. A bad reaction to vaccination during this time left him weary of any future jabs. Author Michael Wilrich of the 2011 nonfiction novel Pox: An American History claims that Jacobson may have even believed his family was naturally predisposed to experiencing dangerous symptoms after receiving the smallpox vaccine. Clearly, Jacobson would not get vaccinated without a fight.

Indeed, after his refusal to receive the dose, Jacobson was fined the customary $5. Considering Massachusetts’s compulsory vaccination law unfair, Jacobson decided to sue, claiming the law infringed on his individual liberties. For the next three years, the case went from court to court, eventually ending up in the highest court of the land: the Supreme Court itself. The Court’s decision would have wide-ranging implications not just for the effectiveness of vaccine laws, but also the extent of public health policies in general.

The justices ruled in Massachusetts’s favor in a 7–2 decision. Specifically, they held in the majority decision, delivered by Justice John Marshall Harlan, that “in every well ordered society charged with the duty of conserving the safety of its members, the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint.”

Ultimately, this meant that in pursuit of protecting the general public’s well-being, some individual liberties, such as the right to refuse a vaccine, would have to be sacrificed. Because the city of Cambridge had been experiencing a smallpox outbreak, it was in the public’s best interest, the Court held, to require smallpox vaccinations to curb the spread of the disease. The Court also included special provisions for immunocompromised people, realizing that requiring vaccines in those instances would be inhumane.

Without this decision, epidemiologists and other public health officials likely would not be able to accomplish their tasks as effectively, if at all. The complete eradication of smallpox globally eventually became certified in 1980, thanks in part to the mandatory vaccination laws that were upheld decades prior.