WaPo | Across the Charles River in Boston, where the smallpox outbreak had begun, the board of health chairman wasn’t so mild. Samuel Durgin had offered free vaccinations to hundreds of thousands of residents, but when that failed to stem the tide of infected patients, he enlisted “virus squads” — gangs of policemen and medical officials who held down and forced people, often homeless men, to be vaccinated, according to the New England Journal of Medicine. One man was beaten so badly by police that after he was vaccinated he had to get stitches for a wound to his head.
Durgin had also publicly challenged any anti-vaccine individuals to come with him to the island where sick patients were isolated and treated. One, Immanuel Pfeiffer, accepted. He nearly died of smallpox. Many were angered that Durgin let Pfeiffer back into the community before he fell ill, where he could have ignited another outbreak, but Durgin thought the headlines — “Anti-vaccinationist May Not Live,” “Chairman Durgin Comes Up Smiling” — were worth the risk, according to the New England journal.
Still, the outbreak continued to spread, and not just to Cambridge but also to within two blocks of Jacobson’s home. So when Spencer returned and the pastor still refused, he did what the law allowed him to do: He fined Jacobson $5 (about $153 today).
Instead of paying the fine, Jacobson and a handful of other vaccine refusers appealed to a higher court, where they caught the attention and support of anti-vaccination societies. Those societies provided Jacobson with powerful attorneys, who argued the case all the way to the Supreme Court.
There had been a number of decisions in other state courts on compulsory vaccination laws, and they were all over the map. Some upheld the laws, some struck them down or placed limitations. Clearly, a national policy was needed.
The Supreme Court handed down its decision in February 1905; in a 7-2 opinion, Justice John Marshall Harlan — a former Kentucky enslaver who fought for the Union in the Civil War and wrote a blistering dissent against Plessy v. Ferguson — said public health could supersede individual rights:
“[T]he liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly free from restraint. There are manifold restraints to which every person is necessarily subject for the common good.”
While the high court in Massachusetts had ruled in favor of the board of health, it also made clear that “it is not in their power to vaccinate [Jacobson] by force.” The Supreme Court didn’t contradict this, and in fact, placed more safeguards, saying “common good” laws had to be reasonable. That’s important, because “virus squads” weren’t limited to Boston; immigrants in tenements were also forcibly vaccinated in New York City, as were Black Americans in Kentucky.
By the time of the Supreme Court’s decision, nearly three years after Jacobson had first refused to be vaccinated, the smallpox outbreak in Cambridge had died down and would never return. (Smallpox was declared eradicated from the planet in 1979.)
The government began regulating the quality of vaccines, and in 1922, another Supreme Court case, Zucht v. King, specifically affirmed proof of vaccination laws for public schoolchildren.
Jacobson paid his fine and went back to his mild-mannered life of preaching to his flock. The anti-vaccine movement had only just begun.
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