Mandates & Exemptions

Vaccine mandates have been a feature of American public health law for over a century. This page traces the legal history of vaccine requirements in the United States, from early smallpox mandates through modern school requirements and COVID-19 policies.

Constitutional Foundation

The legal authority for vaccine mandates rests on two constitutional principles:

• Police power: States have authority to enact laws protecting public health
• Compelling interest: The government can require actions to protect community health

Key Supreme Court Cases

1. Jacobson v. Massachusetts (1905): Upheld mandatory smallpox vaccination, establishing state police power
2. Zucht v. King (1922): Upheld school vaccination requirements
3. Bruesewitz v. Wyeth (2011): Ruled that VICP provides exclusive remedy for vaccine injuries

Historical Timeline

• 1902: Boston mandates smallpox vaccination
• 1905: Jacobson v. Massachusetts upholds mandate
• 1922: Zucht v. King upholds school requirements
• 1962: Model State Immunization Act developed
• 1970s-80s: All 50 states adopt school vaccination requirements
• 1990s: Religious exemptions become widespread
• 2015-2019: States tighten exemption laws
• 2020-2021: COVID-19 vaccine mandates and legal challenges

Types of Mandates

• School requirements: Required for attendance at public and private schools
• Healthcare worker requirements: Hospitals and healthcare facilities
• Military requirements: Required for all service members
• Employment requirements: Private employer mandates

Sources & Citations

• Oyez: Jacobson v. Massachusetts
• CDC: Vaccination Laws