Jacobson v. Massachusetts

In this decision, the Supreme Court addressed for the first time the issue of compulsory vaccination. The decision upheld the right of a state under its police power to provide for compulsory vaccination and to delegate to a municipality the authority to determine when compulsory vaccination was necessary. The decision was welcomed by states in an era when smallpox epidemics were common.

In the fourteenth century, when the bubonic plague was sweeping through England, the English government attempted to control the spread of the disease by passing public health laws imposing quarantines and requiring the burning of victims' household goods and the mandatory cleaning of city gutters. Failure to comply could result in criminal punishment, e.g., the searing of an ear lobe with a hot iron to brand the law breaker. In the nineteenth century, the concern was not the plague, but smallpox, a highly contagious and deadly disease. In 1796, the British physician Edward Jenner discovered a vaccination for smallpox, and vaccination became compulsory in Britain in 1853. Medical studies during the last half of the nineteenth century reported a significant reduction in the prevalence of the disease, and in mortality, amongst vaccinated populations. In the United States, by the early 1900s, most states had passed public health laws authorizing compulsory smallpox vaccination of all inhabitants in the event of an outbreak. Although by 1900, most physicians and most of the public had accepted vaccination as a effective preventative measure, this acceptance was not unanimous. Some physicians and some of the public objected to vaccination on health or philosophical grounds.

In 1902, the board of health of the city of Cambridge, Massachusetts adopted a regulation requiring all inhabitants of the city to be vaccinated against smallpox. A Massachusetts statute authorized the board of health to impose compulsory vaccination if it were necessary for public health or safety. Henning Jacobson, an inhabitant of the city, refused to be vaccinated, and the city filed criminal charges against him. A jury convicted Jacobson after the trial judge excluded his offers of proof and rejected his requested jury instructions. Jacobson offered to prove that vaccination did not prevent smallpox and instead harmed the person vaccinated and that he and his son had reacted adversely to vaccinations in the past. His requested jury instructions asserted that compulsory vaccination violated the U.S. Constitution. On appeal, the supreme judicial court of Massachusetts sustained the conviction, ordering Jacobson jailed until he paid a $5.00 fine. Jacobson appealed to the U.S. Supreme Court.