Jacobson v. Massachusetts

In a 7-2 decision, the U.S. Supreme Court affirmed the conviction, upholding the right of the city to impose and enforce compulsory smallpox vaccination on all its inhabitants, including those who objected. On appeal, the Court limited its discussion to Jacobson's claim that compulsory vaccination violated the Fourteenth Amendment. With respect to this claim, Jacobson argued that

his liberty is invaded when the state subjects him to fine or imprisonment for neglecting or refusing to submit to vaccination; 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; and that the execution of such a law against one who objects to vaccination, no matter for what reason, is nothing short of an assault upon his person.

Before deciding whether the compulsory vaccination statute violated the Fourteenth Amendment, the Court had to determine the scope and meaning of the statute. To do this, the Court looked to the opinion of the supreme judicial court of Massachusetts. Quoting extensively from that opinion, which upheld the exclusion of offers of proof that vaccination was ineffective and dangerous, the Supreme Court defined the scope of the statute to require. As a general rule, adults not under the guardianship and remaining within the limits of the city had to submit to the compulsory vaccination regulation adopted by the board of health.

The Supreme Court then addressed the issue of the statute's constitutional validity. The Court recognized the state's authority under its police power to enact state health laws and to vest power in local governments to administer those laws. "Police power" is the power that the state did not surrender to the federal government under the Constitution when it became a member of the Union. This power is limited only by the condition that any local law not infringe upon any constitutional right. The constitutional right Jacobson claimed compulsory vaccination violated was his "liberty" to care for his own body and health in the way that seemed best to him. The Court rejected Jacobson's broad definition of "liberty," saying

[Liberty] does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good . . . Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others . . . [Liberty] is not unrestricted license to act according to one's own will. It is only freedom from restraint under conditions essential to the equal enjoyment of the same right by others. It is, then, liberty regulated by law.

Applying these legal principles to the case before it, the Court ruled first that the state did not act unreasonably or arbitrarily in allowing the city board of health to determine that compulsory vaccination was necessary. Moreover, the city did not act arbitrarily in deciding that conditions in the city warranted compulsory vaccination. At the time the regulation was adopted, evidence indicated that smallpox was prevalent and increasing in the city, and most of the medical profession and the public believed that vaccination would stop the spread of the disease. As to the rights of an individual who objects to vaccination, the Court stated, "it was the duty of the constituted authorities primarily to keep in view the welfare, comfort, and safety of the many, and not permit the interests of the many to be subordinated to the wishes or convenience of the few." The power of the public to guard itself against imminent danger does not depend "in every case involving the control of one's body upon [a person's] willingness to submit to reasonable regulations established by the constituted authorities, under the sanction of the state, for the purpose of protecting the public collectively against such danger."