In 1901, a deadly smallpox epidemic swept through the northeast, prompting the Boston and Cambridge boards of health to order vaccination for all residents. But some refused to be vaccinated, claiming the vaccine order violated their personal freedoms under the Constitution.
One of those resisters, a Swedish-born pastor named Henning Jacobson, led his anti-vaccine crusade to the United States Supreme Court. The country’s top judges issued a landmark 1905 ruling that legitimized the government’s power to “reasonably” infringe on personal freedoms during a public health crisis by fining those who refused vaccination.
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Smallpox panic and a $ 5 fine
A certificate of “protection against smallpox” completed by the United States Marine Hospital Service for John Donaldson, traveling on the SS Chalmette to New Orleans, Havana, Cuba, July 18, 1902.
New York Historical Society / Getty Images
In 1901, the city of Boston recorded 1,596 confirmed cases of smallpox, a highly contagious and fever-causing disease infamous for causing a severe rash on the face and arms that often left survivors scarred for life. In Boston alone, 270 people died of smallpox during the protracted epidemic from 1901 to 1903. This is why public health officials in Boston and neighboring Cambridge issued their mandatory vaccination orders in the United States. hope to achieve the 90% vaccination rate required for herd immunity.
Jacobson, who served as a pastor at a Swedish Lutheran church in Cambridge, was vaccinated against smallpox in Sweden at the age of 6, an experience which he later said caused him “great and extreme suffering” . So when Dr E. Edwin Spencer, chairman of the Cambridge Board of Health, knocked on the Jacobsons’ door on March 15, 1902, the pastor refused the vaccination for him and his son.
Months later, Cambridge was in a real ‘panic’ of smallpox, with the city ordering the closure of all schools, public libraries and churches to stem the spread of the disease. Police officers accompanied health officials like Spencer, who went door-to-door to vaccinate up to 100 people a day.
But while the Cambridge vaccine order was mandatory, it was not a “forced” vaccination. People like Jacobson who refused to be vaccinated were fined $ 5, the equivalent of almost $ 150 today. On July 17, 1902, Dr. Spencer filed a criminal complaint against Jacobson and other anti-vaccine campaigners to collect this $ 5 fine.
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Jacobson goes to court amid vaccination uproar
The larger battle over the validity of the science of vaccination came to a head during the smallpox epidemic. Anti-vaccination groups, citing suspected cases of death and deformity due to bad reactions to the smallpox vaccine, called compulsory vaccination “the greatest crime of the time”, saying it “brought down”[s] tens of thousands of innocent children. “
In response, newspaper editorials called the smallpox vaccination controversy a “conflict between intelligence and ignorance, civilization and barbarism.” the New York Times dismissed anti-vaccine campaigners as “a familiar kind of cranks” who “lacked the power to judge [science]. “
It was against this heated backdrop that Jacobson fought his $ 5 fine, first in a trial court and then on appeal to the Massachusetts Supreme Court. Jacobson wanted to present evidence that the vaccines themselves were dangerous and ineffective, but the judges didn’t want to hear him. Instead, Jacobson’s main argument became: “The compulsion to bring disease into a healthy system is a violation of liberty,” especially the personal liberty he believed guaranteed by state constitutions. States and Massachusetts.
READ MORE: How enslaved African man helped save generations from smallpox
Supreme Court sets precedent in public health
A street scene in Jersey City, New Jersey, depicting vaccinations during the fear of smallpox.
The National Library of Medicine
Massachusetts’ highest court also rejected Jacobson’s claims, instead siding with the authority of public health officials in determining the best methods to tackle an outbreak. Not ready to give up, Jacobson appealed his case to the United States Supreme Court in 1905, where he was accompanied by agents from the Massachusetts Anti-Compulsory Vaccination Association.
In the said case Jacobson vs. MassachusettsJacobson’s attorneys argued that Cambridge’s vaccination order violated their client’s 14th Amendment rights, which prohibited the state from “depriving[ing] any person of life, liberty or property, without legal procedure. The question was therefore whether the “right to refuse vaccination” was one of these protected personal freedoms.
The Supreme Court rejected Jacobson’s argument and called the anti-vaccination movement a stinging loss. Writing for the majority, Justice John Marshall Harlan recognized the fundamental importance of personal liberty, but also recognized that “the rights of the individual to his liberty can sometimes, under the pressure of great dangers, be subject to such restraint, to be enforced by reasonable regulations, as the safety of the general public may require. “
This decision established what has been called the “reasonableness” test. The government had the power to pass laws that restricted individual liberty, if those restrictions – including punishment for violating them – were deemed by the court to be a reasonable means of achieving a public good.
“Ultimately there had to be some sort of real and substantial connection between the law itself and a legitimate objective, which was the health, safety and welfare of the public,” says Anthony Sanders of the Institute for Justice.
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Mandatory school vaccinations and forced sterilizations
the Jacobson This decision set a powerful and controversial precedent for the extent of government authority in the early 20th century.
In 1922, the Supreme Court heard another vaccination case, this time involving a Texas student named Rosalyn Zucht who was barred from attending public school because her parents refused to have her vaccinated. Zucht’s lawyers argued that the school district’s order requiring proof of vaccination denied Rosalyn “equal protection of the laws,” as guaranteed by the 14th Amendment.
The Supreme Court disagreed. Judge Louis Brandeis wrote in the unanimous decision: “Long before this action was brought, Jacobson vs. Massachusetts decided that it was up to a state’s police to provide for compulsory vaccination. These orders do not confer arbitrary power, but only the broad discretion required for the protection of public health. “
In a much darker chapter, the Jacobson The decision also provided legal coverage for a Virginia law that allowed the involuntary sterilization of “weak-minded” individuals in state mental institutions. In the 1920s, eugenics enjoyed wide support in scientific and medical circles, and Supreme Court justices were not immune.
In the infamous case of 1927 Buck vs. Bell, the Supreme Court accepted the questionable “facts” presented in the lower court cases that a young Virginia woman named Carrie Bell came from a long line of “mentally retarded” whose offspring were a burden for the good. be public.
“The principle behind compulsory vaccination is broad enough to cover cutting of the fallopian tubes (Jacobson v Massachusetts, 197 US 11). Three generations of fools is enough, ”Judge Oliver Wendell Holmes wrote in a chilling opinion.
the male The decision opened the floodgates, and by 1930 a total of 24 states had passed involuntary sterilization laws and approximately 60,000 women were ultimately sterilized under those laws.
“Buck vs. Bell is the most extreme and barbaric example of the Supreme Court justifying a law in the name of public health, ”says Sanders.
Supreme Court Rules on Pandemic Lockdown Orders
A health worker takes a nasal swab sample at a COVID-19 testing site at the St. John’s Well Children’s and Family Center, in Los Angeles, California, during the coronavirus pandemic, July 24, 2020.
Valerie Macon / AFP / Getty Images
Much has changed since 1905, including the way the Supreme Court decides whether certain laws and statutes violate an individual’s constitutional rights. From the second half of the twentieth century, the Court began to recognize certain constitutional rights as “fundamental”, notably the freedoms of expression and religion and personal decisions concerning marriage, contraception and procreation.
Towards the onset of the COVID-19 pandemic, as states issued lockdown orders closing businesses and banning large gatherings, several judges justified the restrictions citing Jacobson vs. Massachusetts, since it was the most recent Supreme Court ruling explicitly dealing with state powers during a disease outbreak, even though she was 115 years old.
But in a turnaround, the Supreme Court ruled in 2020 against a broad application of the logic of Jacobson to all COVID-19 lockdown restrictions. In Roman Catholic Diocese of Brooklyn, New York v. Andrew M. Cuomo, the court ruled that New York state had violated the constitutional rights of citizens wanting to assemble safely in churches and synagogues during the pandemic. The reasoning was that lockdown laws completely banned religious gatherings while allowing secular businesses to operate at limited capacity.
“Jacobson barely supports the removal of the Constitution during a pandemic, ”Justice Neil Gorsuch wrote for the 5-4 majority. “This decision involved an entirely different mode of analysis, an entirely different right and an entirely different type of restriction.”
READ MORE: See full pandemic coverage here.
