Should Governments Impose Mandatory Vaccinations?
Analyzing the history of vaccines and the controversy of vaccine mandates.
Photo Source: AAMC
In the days before patient safety laws (1796, to be exact), British physician Edward Jenner infected James Phipps, the 8-year-old son of his gardener, with cowpox. He had heard that people infected with cowpox would be immune to smallpox, and he wanted to test if that were true.
About six weeks later, Jenner infected Phipps with smallpox. Fortunately for Phipps, cowpox and smallpox are related diseases, and people exposed to cowpox are in fact immune to smallpox. Jenner published this discovery, and before long cowpox was being widely administered as a smallpox vaccine, saving thousands of lives.
It’s easy to hear a story like this and assume that people looked at the evidence, saw the success of the method, and immediately and wholeheartedly adopted it for their own use. That’s not the case.
Due to the difficulty of transporting cowpox material and the unsafe medical practices typical of the time, the vaccine was not always effective and could be downright dangerous. Some clergymen objected, considering it to be against God’s will. Others simply mistrusted its efficacy.
Despite these objections, the first vaccine mandate in the United States was instituted by the Massachusetts state government in 1809, less than 15 years after Jenner’s discovery. In the years following, smallpox vaccination would be required for military service, with some exemptions, and eventually it would be a requirement for enrollment in any public school. It wasn’t until 1905, with the court case Jacobson v. Massachusetts, that someone brought legal objections to a vaccine mandate.
Henning Jacobson, citing a bad reaction to a previous vaccination, refused to be vaccinated for smallpox and was fined $5. He objected, and the case eventually went to the Supreme Court, which ruled that states did have the right to enforce vaccine mandates for the sake of public health. Contrast that with May of 2023, where the Fifth Circuit Court of Appeals blocked a COVID-19 vaccine mandate for federal workers. Clearly, the debate remains active, but there may have been a shift in attitude.
The main controversy of vaccine mandates is the debate over which worldview should take precedence: the bodily autonomy of an individual or the general welfare of a community as a whole.
The first argument is based on the idea that an individual has the right to make all health decisions for themself, regardless of how beneficial a treatment may be. We’ve seen that argument during the recent COVID-19 pandemic, where many people chose not to get vaccinated for personal reasons.
Another facet of this is that, at least in America, we view government and community as means to preserve the liberties of the individuals. That’s clear in the Declaration of Independence, where Thomas Jefferson states that “to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed.” In other words, the role of government is not to control the behavior of citizens, which a vaccine mandate does, but to protect their liberties, including that of medical autonomy.
However, if we turn to the Constitution, it’s stated that the government was established to “provide for the common defense” and “promote the general welfare.” This second argument was also on display during the pandemic, where governments around the world instituted vaccine mandates with varying levels of strictness. The argument here is that although a vaccine mandate may violate an individual’s right to choose, the potential benefit to the community outweighs the cost of taking away that choice.
It’s a difficult conversation to have, as I’m sure everyone knows in the years following the COVID-19 pandemic, but I think it’s worth having. Because of the efforts of individual governments and the World Health Organization, smallpox has been completely eradicated. But once we start ignoring an individual’s choice, will we ever decide to stop?
Think of it this way: eventually, there will be another pandemic. When that happens, will you be in favor of a vaccine mandate for the common good? Or will you take the risk in order to preserve your individual freedoms?
Best,
Grace for the Don’t Count Us Out Yet Team
How interesting. After all I've read on this topic, I only here learned about the questionable ethical genesis of the smallpox vaccine, and the early Supreme Court case backing state mandated vaccinations. I am not sympathetic to anti-vaxxer arguments, but the refuseniks are a complex crowd. I know of one medical doctor who is such. I believe in that case, the family is both vax resistant and home-schooled. No way, nor reason, to vaccinate people against distrust of government.