The Moral Dilemma for Compulsory Vaccinations in America

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By Katya Cox-Kruger.

As Covid-19 continues to spread with deadly consequences and increasing strain on medical infrastructure, governments across the world are searching for ways to increase vaccination rates among their citizens- some with more success than others. The necessity of mass vaccination is indisputable and its historical effectiveness can be seen in the eradication of diseases such as smallpox and polio. According to the Centers for Disease Control and Prevention (CDC), vaccines offer at least 90% protection which makes it an absolutely essential tactic in managing the spread of Covid. With no end in sight, the question arises as to the role of governments in the vaccination process. The January 13th United States Supreme Court decision ruled that the government could not force companies with over 100 employees to demand that their employees be vaccinated or regularly tested. This took much of the international community by surprise and criticism was swiftly delivered. Applying the United States and their approach with smallpox, it is important to note how the argument for compulsory vaccinations isn’t as clear cut as one may think.

When the United States was struggling with what would become the final outbreak of smallpox at the beginning of the 1900s, compulsory vaccinations were introduced. This was highly effective and is still considered one of the greatest triumphs in America’s medical history. Not only was the vaccination effective in the prevention of smallpox in 95% of people, but it was also proven to lessen the symptoms of infection. Despite this, there was an anti-vaccination protest movement and this conflict went all the way to the Supreme Court case of Jacobson vs Massachusetts in 1905. While Jacobsen made the argument that compulsory vaccination was a violation of his personal freedoms (as many Americans are doing today with the Covid vaccine), Justice John Marshall Harlan spoke on behalf of the majority in striking down that argument by saying “the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand”. So while all are entitled to personal freedoms in the United States, they may be restrained when they interfere with the safety and health of the general public. This not only set a precedent for compulsory vaccinations but also the recognition that the need of the whole precedes the wants of an individual. This established a test of “reasonability” that allowed the government to authorize personal freedom limiting legislation if they believed it was for the good of the public.

However, the precedent set in the law by the ruling of Jacobson vs Massachusetts was used to justify far more than life-saving vaccines. This test of “reasonability” was applied to a law that allowed forced sterilization of individuals in state mental institutions, further supported by the Supreme Court case Buck vs Bell. It was argued that children of “feeble-minded” individuals were a burden for the public and therefore sterilization of the parents was “in the interest of the public”. By 1930, eugenics had spread to 24 states in America and around 60,000 women were sterilized. While this was a dark time in America’s history, it should be used not for arguing against life-saving vaccinations but instead with an understanding of how law and Supreme Court decisions are often open to interpretation and how dangerous that can be for individuals when the tides turn against them. No matter the initial intention, in this case smallpox, these interpretations have a domino effect on legislation that may later be harmful.

Using smallpox as a parallel for Covid in these modern times, it is important to acknowledge the incredibly valuable part that vaccination plays for both of these pandemics. As the death toll rises to more than 860,000 in the United States, vaccination is more important than ever. They are life-saving and are our biggest hope in the current unstable times of lockdowns, travel restrictions, staff shortages, medical supply scarcity, etc. We are only witnessing the tip of the iceberg of the effect that Covid will ultimately have on society and to decide to not get the vaccine is to decide not to protect yourself with a general disregard for the public. While one might say that it should be the moral obligation of the individual that drives their want to vaccinate, it is obvious that that is not enough. 35% of the population remains not fully vaccinated so should the government be able to force individuals to do so in the name of the public good? NPR reports that 97% of those currently in the hospital due to Covid are unvaccinated. So is it the duty of the government to protect the public and the strain on the healthcare system? This Supreme Court says no but that may not always be the case. Compulsory Covid vaccination is being instated in countries such as Austria, Germany, and Indonesia so there is a global movement that may reach the United States. As we wait to see if it does, it is up to individuals to decide what they are willing to do to protect their families, friends, and neighbours.

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