Compulsory COVID-19 Vaccination? : Only as a Policy of Last Resort

Photo by Daniel Schludi on Unsplash The debate regarding the limits of individual liberty and the state’s obligation to promote the common welfare and to protect its citizens is too important to be left to extremists. As more vaccines make their way through Phase III trials[1] and the question of compulsory vaccination presents itself, leaders must address the short- and long-term implications of requiring a specific medical intervention (vaccination) as a condition of community membership[2] versus as a condition of participation in school, work, or other activities. Transparency and openness to compromise are paramount. Broad buy-in on policy which touches such a fundamental human interest, the right of individuals to control their own bodies, is crucial to restore or ensure continued trust in science and American institutions and to prepare the country to combat future problems. This paper argues that universal compulsory vaccination (by state or county) should be implemented only as a policy of last resort. Public health officials must first weigh all reasonable alternatives, including educational initiatives, tax credits (rather than penalties), and variously-formulated requirements for vaccination of subsets of the population as a condition of participation in public activities. HISTORY In 1902, the Board of Health of Cambridge, Massachusetts, using authority delegated to it by the state legislature, required smallpox vaccination or revaccination for all healthy residents above the age of 21. Those who refused were subject to a five dollar per day fine. A pastor by the name of Henning Jacobson was prosecuted, fined, and ultimately ordered committed for refusing to pay that fine. In Jacobson v. Massachusetts, Justice John Marshall Harlan wrote the majority opinion for a seminal 7-2 Supreme Court decision upholding the right of the state to compel vaccination under certain circumstances. Underpinning the Court’s conclusion was a tense and uncertain compromise between the tenets of social-compact theory and ...