Jacobson v. MA; Vaccine Mandates & Religious Exemptions

One of the principle responsibilities of government is to protect the public health, so vaccine mandates have been around about as long as there have been vaccines. But, so have antivaxxers and that has often caused tensions in society. Antivaxxers believe they can avoid the life-saving shots based on their right to control what is put into their bodies. While bodily integrity and personal autonomy are important and recognized liberties, they has never trumped the government's duty to protect society from deadly diseases.

The United States Supreme Court faced the issue squarely in the case of Jacobson v. Massachusetts in 1905.

In 1902, the Board of Health of the city of Cambridge, Massachusetts, adopted the following regulation:

"Whereas, smallpox has been prevalent to some extent in the city of Cambridge and still continues to increase; and whereas it is necessary for the speedy extermination of the disease that all persons not protected by vaccination should be vaccinated, and whereas, in the opinion of the board, the public health and safety require the vaccination or revaccination of all the inhabitants of Cambridge; be it ordered, that all the inhabitants of the city who have not been successfully vaccinated since March 1, 1897, be vaccinated or revaccinated."

Jacobson refused the vaccine arguing that the mandate violated his rights under the 14th Amendment Equal Protection Clause, among other things. The Court rejected those arguments, finding that any society charged with maintaining the safety of its citizens must occasionally limit individual liberties. Faced with a public health crisis, the needs of the many outweigh the desires of a few, and the state has a duty to enact laws protecting the health and safety of all its citizens.

To be fair, Jacobson was decided in an era in which the Court gave great deference to state health and safety regulations, but the case has remained binding precedent ever since. In Zucht v. King in 1922, the Court upheld a San Antonio, Texas regulation excluding students from public and private schools who were not vaccinated for smallpox. The plaintiff's attorneys argued the vaccine policy violated Zucht’s 14th Amendment due process rights. However, Justice Louis Brandeis, writing for the majority, found that “long before this suit was instituted, Jacobson v. Massachusetts, had settled that it is within the police power of a state to provide for compulsory vaccination.” And, earlier this year, a federal court declined to grant an injunction against Indiana University's vaccine mandate.

If there is an open question concerning mandates, especially considering the Supreme Court's very conservative majority, it is the question of religious exemptions. There is no precedent saying that a state or local government must offer such exemptions, but they are common in most states for immunization against such diseases as measles, mumps and rubella. The problem with such exemptions is that they can greatly reduce the percentage of individuals vaccinated and prevent a community from reaching "herd immunity." That puts everyone at risk.

Bill of Health, Harvard Law: "The problem is that the same people who eagerly promote anti-vaccine misinformation are just as eager to misuse religion to avoid vaccinating, and have no hesitation or compunction about coaching others to do the same. And without policing, it is easy for those misled by anti-vaccine misinformation to use the religious exemption."

Moreover, there are some real ethical questions concerning religious exemptions as Curtis Chang of the Duke Divinity School recently pointed out in an opinion piece for the New York Times.

New York Times: "First, there is no actual religious basis for exemptions from vaccine mandates in any established stream of Christianity. Within both Catholicism and all the major Protestant denominations, no creed or Scripture in any way prohibits Christians from getting the vaccine. Even the sect of Christian Scientists, which historically has abstained from medical treatment, has expressed openness to vaccines for the sake of the wider community. The consensus of mainstream Christian leaders — from Pope Francis to Franklin Graham — is that vaccination is consistent with biblical Christian faith."

However, this Fall as vaccine mandates pile up across America, some without religious exemptions, the Supreme Court will likely be asked to rule on the issue. The current Supreme Court might strike down a mandate without any religious exemptions unless the state can clearly demonstrate that a high number of exemptions threaten public health.

#health #law

By: Don Lam & Curated Content