Academic journal article Current Politics and Economics of the United States, Canada and Mexico

Mandatory Vaccinations: Precedent and Current Laws *

Academic journal article Current Politics and Economics of the United States, Canada and Mexico

Mandatory Vaccinations: Precedent and Current Laws *

Article excerpt

HISTORY AND PRECEDENT

At the end of the 20th century, the Centers for Disease Control and Prevention (CDC) published its list of the "Ten Great Public Health Achievements" for the United States from 1900 to 1999. Number one on the list was vaccination.1 Vaccination has resulted in the eradication of smallpox worldwide, and in the control of many other vaccine-preventable diseases.2 Mandatory vaccination programs, such as school immunization requirements, have played a major role in controlling rates of vaccine-preventable diseases in the United States.3

Historically, the preservation of the public health has been the primary responsibility of state and local governments, and the authority to enact laws relevant to the protection of the public health derives from the state's general police powers.4 With respect to the preservation of the public health in cases of communicable disease outbreaks, these powers may include the institution of measures such as quarantine and isolation5 or the enactment of mandatory vaccination laws.6 Mandatory vaccination laws were first enacted in the early 19th century, beginning with Massachusetts' smallpox vaccination law in 1809.7

Jacobson v. Massachusetts is the seminal case regarding a state or municipality's authority to institute a mandatory vaccination program as an exercise of its police powers.8 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."9 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."10 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."11

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."12 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."13 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:14

[I]t might be that an acknowledged power of a local community to protect itself against an epidemic threatening the safety of all, might be exercised in particular circumstances and in reference to particular persons in such an arbitrary, unreasonable manner, or might go so far beyond what was reasonably required for the safety of the public, as to authorize or compel the courts to interfere for the protection of such persons.

STATE MANDATORY VACCINATION LAWS

School Vaccination Requirements

Every state and the District of Columbia has a law requiring children entering school to provide documentation that they have met the state immunization requirements.15 In 1827, Boston was the 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. …

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