Mandatory Vaccinations: Precedent and Current Laws Page: 2 of 6
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In Jacobson, the Supreme Court upheld a Massachusetts law that gave municipal boards
of health the authority to require the vaccination of persons over the age of 21 against
smallpox, and determined that the vaccination program instituted in the city of Cambridge
had "a real and substantial relation to the protection of the public health and safety."6 In
upholding the law, the Court noted that "the police power of a State must be held to
embrace, at least, such reasonable regulations established directly by legislative enactment
as will protect the public health and the public safety."7 The Court added that such laws
were within the full discretion of the state, and that federal powers with respect to such
laws extended only to ensure that the state laws did not "contravene the Constitution of
the United States or infringe any right granted or secured by that instrument."
The Court addressed constitutional concerns raised by the petitioner in Jacobson, but
remained unconvinced that his rights were "contravened" by the mandatory vaccination
program. The petitioner argued that "a compulsory vaccination law is unreasonable,
arbitrary and oppressive, and, therefore, hostile to the inherent right of every freeman to
care for his own body and health in such way as to him seems best; and that the execution
of such a law against one who objects to vaccination, no matter for what reason, is
nothing short of an assault upon his person."9 The Court rejected the petitioner's
constitutional challenge and noted that "the liberty secured by the Constitution of the
United States to every person within its jurisdiction does not import an absolute right in
each person, to be, at all times and in all circumstances wholly free from restraint."10
However, the Court did acknowledge limits to the state's power to protect the public
health and set forth a reasonableness test for public health measures:"
6 Id. at 31. The Massachusetts statute in question reads as follows: "Boards of health, if in their
opinion it is necessary for public health or safety, shall require and enforce the vaccination and
revaccination of all the inhabitants of their towns, and shall provide them with the means of free
vaccination. Whoever refuses or neglects to comply with such requirement shall forfeit five
dollars." M.G.L.A. c. 111, 181 (2004).
7Id. at 25.
8
9 Id. at 26.
10 Id. In Adams v. Milwaukee, 228 U.S. 572, 581-82 (1913), the Supreme Court reaffirmed
Jacobson's holding that states may delegate the power to order vaccinations to local
municipalities for the enforcement of public health regulations. See also, Zucht v. King, 260 U.S.
174, 176 (1922), holding that vaccination laws do not discriminate against schoolchildren to the
exclusion of others similarly situated, i.e., children not enrolled in school. In Prince v.
Massachusetts, 321 U.S. 158 (1944), the Court held generally that the right to practice religion
does not include the liberty to jeopardize the well being of minors.
" Id. at 28. Smallpox vaccinations are no longer administered since smallpox has been
eradicated worldwide as of 1980. See World Health Organization, Smallpox Fact Sheet, at
[http://www.who.int/mediacentre/factsheets/smallpox/en/]. One author has suggested that while
Mr. Jacobson might be successful in his refusal to be vaccinated against smallpox today since
smallpox has been eradicated, the threat of terrorists using smallpox as a weapon might make the
use of the vaccine a reasonable measure yet again. Andrew Zoltan, JACOBSON revisited:
Mandatory Polio Vaccination as an Unconstitutional Condition, 13 GEO. MASON L. REV. 735,
747-752 (2005). See also CRS Report RS21288, Smallpox: Technical Background on the
Disease and Its Potential Role in Terrorism, by Frank Grottron.
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Swendiman, Kathleen S. Mandatory Vaccinations: Precedent and Current Laws, report, January 7, 2008; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc809581/m1/2/: accessed April 18, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.