Jacobson v. Massachusetts [SCOTUSbrief]

At the turn of the twentieth century, Massachusetts enacted a law that allowed cities to enforce the vaccination and revaccination of all the inhabitants if, in their opinion, it is necessary for the public health or safety. If a person refused to be vaccinated, he was fined $5. In 1902, Henning Jacobson of Cambridge was convicted of refusing to comply with the requirement of the Board of Health to be vaccinated against smallpox.

Jacobson appealed the case all the way to the United States Supreme Court. Jacobson alleged that the Massachusetts law violated the due process clause of the Fourteenth Amendment. He 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.

But the Court rejected this position. "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 freed from restraint. " Harlan concluded that the Massachusetts law was not arbitrary, but was justified by the necessities of the case.

But he acknowledged that the state's police power could 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 with the protection of such persons. Justice Harlan laid out two separate tests to determine whether such a law is valid. First, the court asks if a statute purporting to have been enacted to protect the public health, the public morals, or the public safety has no real or substantial relation to those objects.

Second, the court asks if the law is beyond all question a plain, palpable invasion of rights secured by the fundamental law. In either case, the court has the duty to so adjudge and thereby give effect to the Constitution. The first test resembles a sort of means and scrutiny that will become a staple of constitutional adjudication later in the twentieth century.

Here the commonwealth's goal, or end, was to reduce the spread of smallpox. The means chosen, a vaccination mandate, has a substantial relation to reducing the spread of the outbreak. The second test resembles the Court's modern fundamental rights framework.

There are fundamental rights that are so important that they cannot be violated for any reason. Two decades later, in Buck v. Bell, Justice Holmes misread the scope of Jacobson, a decision that he joined.

Justice Holmes analogized government-compelled sterilization to government-compelled vaccination. Holmes concluded that the principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. But Jacobson did not actually sustain compulsory vaccination.

The Massachusetts Supreme Judicial Court observed if a person should deem it important that vaccination should not be performed in his case, and the authorities should think otherwise, it is not in their power to vaccinate him by force, and the worst that could happen to him would be the payment of the penalty of $5. Being forced to pay a nominal fine does not invade any fundamental right. Carrie Buck did not have the option of paying a fine to avoid sterilization.

Holmes' misreading of Jacobson would be followed by many litigants and judges. Jacobson remains important in modern debates over vaccinations and public health. Jacobson recognizes that the states have certain powers during public health crises, but this opinion must be understood as a product of its time and not through the lens of modernity.