[The defendant, Mr. Jacobson, refused to be vaccinated (for smallpox) by the local Massachusetts authorities in 1902, offering to] “prove that vaccination ‘quite often’ caused serious and permanent injury to the health of the person vaccinated; that the operation ‘occasionally’ resulted in death; that it was ‘impossible’ to tell ‘in any particular case’ what the results of vaccination would be or whther it would injure the health or result in death; that ‘quite often’ one’s blood is in a certain condition of impurity when it is not prudent or safe to vaccinate him; that there is no practical test by which to determine..whether one’s blood is in such a condition; that vaccine matter is ‘quite often’ impure and dangerous..; that the defendant refused to submit to vaccination for the reason that he had ‘when a child’ been caused great and extreme suffering for a long period of time by a disease produced by vaccination, and that he had witnessed a similar result of vaccination not only in the case of his son, but in the cases of others.”
The previous decision made by the Massachusetts Supreme Court found that Jacobson had not proved these offers and “the defendant did not offer to prove that, by reason of his then condition, he was in fact not a fit subject of vaccination at the time he was informed of the requirement of the regulation adopted by the Board of Health”. The new decision before the U.S. Supreme Court was neither to prove or disprove the efficacy of vaccination, but to determine the right of the State to pass its own statutes of public health.
The document webpage above from Jacobson’s case records that, in the lower court trial, the “defendant refused to be vaccinated…the defendant made numerous offers of proof. But the trial court ruled that each and all of the facts offered to be proved by the defendant were immaterial, and excluded all proof of them. The defendant..asked numerous instructions to the jury, among which were the following: That ..of the Revised Law(s) of Massachusetts was in derogation of the rights secured to the defendant by the Preamble to the Constitution of the United States…That the section referred to was in derogation of the rights secured to the defendant by the Fourteenth Amendment…especially..of the clauses of that amendment providing that no state shall make or enforce any law abridging the privileges or immunities of citizens..nor deprive any person of life, liberty or property without due process…nor deny to any person..equal protection of the laws…”. A verdict of guilty was returned…The case was then continued for the opinion of the Supreme Judicial Court of Massachusetts. That court..sustained the action of the trial court.
[the Mass. Supreme Court..delivered the opinion]..Although the Preamble indicates the general purposes for which the people ordained and established the Constitution, it has never been regarded as the source of any substantive power conferred on the Government of the United States or on any of its Departments…The Supreme Judicial Court of Massachusetts said in the present case: “Let us consider the offer of evidence which was made by the defendant Jacobson…which he offered to prove as to what a vaccine consists of, is nothing more than a fact of common knowledge upon which the statute is founded and proof of it was unnecessary and immaterial…his personal opinion, which could not be taken as correct..[and] could not affect the validity of the statute nor entitle him to be excepted…
The other eleven propositions all relate to alleged injurious or dangerous effects of vaccination. The defendant offered to prove or show by competent evidence these so-called facts. Each of them in its nature, is such that it cannot be stated as a truth, otherwise than as a matter of opinion. The only ‘competent evidence’ that could presented to the court..was the testimony of experts giving their opinions. It would not have been competent to introduce the medical history of individual cases. [The judges] would have considered this testimony of experts in connection with the facts, that for nearly a century most of the members of the medical profession have regarded vaccination, repeated after intervals, as a preventive..while they have recognized the possibility of injury to an individual…risk of such an injury too small to be seriously weighed as against the benefits…If the defendant had been permitted to introduce such expert testimnoy as he had in support of these several propositions, it could have changed the result.. [but] would not have justified the court in holding that the legislature had transcended its power in enacting this statute.
The authority of the State to enact this statute is to be referred to what is commonly called the police power –a power which the State did not surrender when becoming a member of the Union under the Consitution. [This court]..has distinctly recognized the authority of a State to enact quarantine laws and “health laws of every description”… The defendant insists 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 a way as to him seems best, and that the execution of such a law…is nothing short of an assault upon his person. But the liberty secured by the Constitution..to every person..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. On any other basis, organized society could not exist with safety for its members. Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy…This court has more than once recognized it as a fundamental principle that “persons and property are subjected to all kinds of restraints and burdens in order to secure the general comfort, health and prosperity of the State…”
Applying these principles to the present case…[the] authority to determine for all what ought to be done in such an emergency..was appropriate for the legislature [and] a Board of Health..because of their fitness to determine such questions…[A] community has the right to protect itself against an epidemic of disease which threatens the safety of its members..[and] to affirm..the methods most usually employed to eradicate that disease…[This] court recognized the right of a State to pass sanitary laws, laws for the protection of life, liberty, health or property within its limits, laws to prevent persons and animals suffering under contagious or infectious diseases, or convicts, from coming within its borders….[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.
An American citizen..may..be held in quarantine against his will…he may be compelled, by force if need be, against his will and without regard to his personal wishes,..pecuniary interests, or even his religious or political convictions, to take his place in the ranks of the army of his country and risk the chance of being shot down in its defense..
[The vaccination] statute..makes no exception in the case of adults..[and] is equally applicable to all…The latest case upon the subject of which we are aware is Viemeister v. White, President & c., decided very recently by the Court of Appeals of New York…That case involved the validity of a statute excluding from the public schools all children who had not been vaccinated…[text 1="judgement" 2="included" language="of"][/text][/text] “It must be conceded that some layman..and some physicians of great skill and repute, do not believe that vaccination is a preventive…The common belief, however, is that it has a decided tendency to prevent the spread of..fearful disease…While not accepted by all, it is accepted by the mass of the people as well as by most members of the medical profession. It is generally accepted in theory and generally applied in practice..like common knowledge [and] does not require evidence..but may be acted upon without proof by the legislature and the courts”…The possibility that the belief may be wrong, and that science may yet show it to be wrong, is not conclusive, for the legislature has the right to pass laws which, according to the common belief of the people, are adapted to prevent the spread of contagious diseases…practical legislation admits to no other standard…
While we do not decide and cannot decide that vaccination is a preventive.., we take judicial notice of the fact that this is the common belief of the people of the State [and] hold that the statute in question is a health law, enacted in a reasonable and proper exercise of the police power.
[Justices Brewer and Peckham, dissent]