Should COVID vaccinations be mandatory for everyone?

Parents have never been so worried about their own health and the health of their children. …Except when we had epidemics of smallpox. And measles. And polio. And tuberculosis…

The vaccination wars are nothing new.

People have struggled for centuries to conquer plagues, and doubts are always part of the story. From the Chinese in the year 1000 creating inoculations for smallpox to major scientific breakthroughs such as antitoxins and vaccines, controversy always accompanies efforts to keep people safe.

Throughout the world, states and cities have passed vaccine laws to protect against disease. Those opposed to vaccinations have resisted, declaring an individual right to refuse.

Anti-Vaccination Society of America invitation to join membership, 1902. The Historical Medical Library of The College of Physicians of Philadelphia. Scrapbook of Anti-Vaccinations Clippings. 8c242.

Surging cases of the delta variant of Covid-19 have brought the philosophical divide over vaccination to center stage. Vaccinated people are increasingly upset with those who refuse to be vaccinated, thereby extending the spread of the virus. Many of those opposed to vaccination also vigorously oppose requirements to wear a mask.

New this year to the vaccination debate is an active disinformation campaign that aims to convince people not to get vaccinated. The result: a surge of sick people is now filling hospitals beyond capacity. People are dying.

The Supreme Court and the right to public safety

We have heard many of these arguments before. Several US Supreme Court decisions in the early 1900’s clarified the rights of states to protect public safety using quarantines and vaccinations.

The classic question: Can states impose safety restrictions that limit individual rights? The quick answer: Yes.

Quarantines: Louisiana, facing an outbreak of yellow fever more than a century ago, passed a quarantine law that allowed communities to keep people from entering cities and towns. The US Supreme Court upheld it.(1902)

Vaccination law: Around the same time, in the midst of a smallpox epidemic, Cambridge, Massachsetts passed a law to fine people who refused to be vaccinated. If you did not pay the fine, you could be imprisoned. Henning Jacobson refused to be vaccinated on personal medical grounds and sued, calling the law unconstitutional. The US Supreme Court ruled that it is within the police power of a state to enact a compulsory vaccination law (1905). Especially during an epidemic, individual liberty is not absolute. The Washington Post provides a fascinating account of this case concluding that it provides a legal precedent for coronavirus vaccine passports.

Mandatory School Vaccinations: In 1922, Rosalyn Zucht, a student from San Antonio, Texas, was excluded from a public school for failure to present proof of vaccination. The US Supreme Court, citing the Jacobson case, said “a state may, consistently with the federal Constitution, delegate to a municipality authority to determine under what conditions health regulations shall become operative.” It is within the power of a state to provide for compulsory school vaccination.

Can we mandate COVID vaccinations for everyone?

Can we now mandate COVID vaccinations for everyone, with appropriate exemptions for medical issues? So far in this pandemic, states have not been this bold. But the Delta variant is highly contagious, and deadly. As of this writing, the vaccines have been shown to be safe for healthy adults and teens 12 and older. Hopefully, research will find them safe for younger children, too. Will a universal mandate be the next step?

Legal experts believe that carefully drafted mandates can pass constitutional muster. (I know, I know. There will be some experts who argue otherwise. My money is squarely on the public safety argument winning the day.)

Want to learn more?

• Read: Mandatory Vaccinations: Precedent and Current Laws,
• Read: A Shot in the Arm: What a Modern Approach to Jacobson v. Massachusetts Means for Mandatory Vaccinations During a Public Health Emergency
• Read/listen: Are Vaccine Mandates Constitutional? (37 min)
• Watch: California State Superintendent of Public Instruction Tony Thurmond and guests discuss Supporting Safe Back to School (54 min)

One thing we know for sure: Vaccines save lives.

Before vaccines, epidemics killed people in large numbers and created serious lifelong health challenges for many more. Remarkably, vaccines have essentially eliminated most of these health risks.

The table below compares other serious preventable diseases in California to the California COVID rates.

Compare those numbers to the impact of COVID

Startling, right? Vaccines save lives in huge numbers. In 2018, there were just 10 deaths in California from the diseases above where vaccines are required. Meanwhile, more than 64,000 in California have died from COVID.

Vaccinations protect children from serious preventable diseases. That's why California, like other states, requires children to be immunized to enroll in school.

Open schools safely

Many who were hesitant to require vaccinations for COVID have changed their views. Randi Weingarten, head of the American Federation of Teachers, now supports mandated vaccines for teachers.

“We are encouraging everyone to get vaccinated,” says California State Superintendent of Public Instruction Tony Thurmond. “Children as young as twelve are now eligible to get vaccinated, and the safety of our communities and schools is dependent on increasing vaccination rates.”

California is the first state in the nation to require that teachers, state employees and health care workers be vaccinated or regularly tested. San Francisco now requires proof of vaccination for entry to certain indoor businesses and to all large indoor events.

As schools and communities tighten safety requirements, they need to keep their courage. Anti-vaccine disinformation is its own kind of virus.

What do you think?

• Should vaccinations be mandatory for everyone in schools, including eligible students?
• Should COVID vaccinations be added to the mandatory vaccine list to enter school?
• Should people in school settings be required to wear masks even if they are vaccinated?
• Should schools be required to operate virtually until faculty and families are vaccinated?
• Who should pay for Covid tests for those who refuse to be vaccinated?
• It is legal in most states for health insurers to charge smokers higher rates. Should the same be true for those who refuse vaccines?