Jacobson v. Massachusetts

A Massachusetts statute let city boards of health require vaccination when they judged it necessary for public health or safety. An adult who refused could be fined $5, but the law gave no power to vaccinate anyone by force. With smallpox prevalent and increasing in Cambridge, the city's board of health ordered on 27 February 1902 that all inhabitants not successfully vaccinated since 1 March 1897 be vaccinated or revaccinated, and it provided free vaccination.

Henning Jacobson, an adult in Cambridge, refused, saying that he and his son had reacted badly to earlier vaccinations. He was prosecuted and fined, the state courts upheld the conviction, and he appealed to the US Supreme Court. He argued that compulsory vaccination was unreasonable, arbitrary and oppressive, and an assault on his person.

The Court decided the case on 20 February 1905, with Justice Harlan writing for the majority and Justices Brewer and Peckham dissenting. Harlan held that the liberty the Constitution protects is not an absolute right to be free of all restraint at all times. Under its police power, he wrote, a community has the right to protect itself against an epidemic that threatens its members, and the legislature could leave the judgment of necessity to a local board of health.

The opinion also set limits. Courts could intervene if such a power was used in an arbitrary or oppressive way, or went beyond what public safety reasonably required. Harlan added that the law should not be read to force vaccination on an adult for whom it would be cruel and inhuman, or who could show that it would seriously impair his health or probably cause his death.

The Court did not always apply those limits. In 1922, in Zucht v. King, it upheld a city rule barring unvaccinated children from school in a brief opinion that did not ask whether the rule was necessary. In 1927, in Buck v. Bell, Justice Oliver Wendell Holmes cited Jacobson when upholding Virginia's law on the involuntary sterilization of people in state institutions judged feeble-minded.