Landmark Supreme Court decisions shaping vaccine mandates, injury compensation, and public health authority.
The U.S. Supreme Court has addressed vaccine law in a small but highly significant set of cases spanning more than a century. These rulings have established the constitutional framework within which vaccine mandates, injury compensation, and manufacturer liability operate today.
The foundational principle — that states have authority to mandate vaccination to protect public health — was established in 1905 and has never been overturned.
The foundational vaccine law case
Henning Jacobson refused a Cambridge, Massachusetts smallpox vaccination mandate and was fined $5. He challenged the mandate as an unconstitutional violation of his liberty.
The Supreme Court ruled 7-2 in favour of Massachusetts. Justice John Marshall Harlan wrote that individual liberty is not absolute and may be restrained by the state when public health and safety demands it.
States have broad police power authority to enact reasonable vaccination mandates. The Court established that this power has limits — mandates must not be arbitrary, oppressive, or unreasonable — but upheld the smallpox mandate.
Jacobson remains the foundational precedent for all vaccine mandate law in the United States. It has been cited in hundreds of subsequent cases including COVID-19 mandate litigation.
Expanding Jacobson to school settings
Rosalyn Zucht was excluded from public school in San Antonio, Texas for failing to provide proof of vaccination. She challenged the school board's authority to require vaccination as a condition of school attendance.
The Supreme Court unanimously upheld the school vaccination requirement, citing Jacobson. The Court held that states may delegate vaccination authority to local school boards and municipalities.
School vaccination mandates are constitutionally permissible. States may condition school attendance on proof of vaccination.
Established the constitutional basis for all U.S. school vaccination requirements that exist today.
Defining the limits of manufacturer liability
Hannah Bruesewitz suffered seizures shortly after receiving a DTP vaccine as an infant. Her family sued vaccine manufacturer Wyeth (later Pfizer), alleging the vaccine was defectively designed.
The Supreme Court ruled 6-2 that the National Childhood Vaccine Injury Act of 1986 (the law that created the VICP) preempts all design defect claims against vaccine manufacturers in state court.
Vaccine manufacturers cannot be sued for design defects in vaccines covered by the VICP, as long as the vaccine was properly manufactured and accompanied by proper warnings. Injured parties must seek compensation through VICP.
Established that the VICP is the exclusive remedy for most vaccine injury claims, protecting manufacturers from tort liability and channelling claims through the federal compensation system.
COVID-19 mandate litigation
The Biden administration issued two federal vaccine mandates in 2021: one for healthcare workers at Medicare/Medicaid facilities (CMS mandate) and one for large employers via OSHA emergency rules.
In consolidated cases decided January 13, 2022, the Supreme Court blocked the OSHA large-employer mandate (finding it exceeded OSHA's statutory authority) but upheld the healthcare worker CMS mandate (finding it within HHS statutory authority).
Federal agencies may mandate vaccines within their statutory authority. OSHA's authority does not extend to a general public health measure like a broad employer mandate. Healthcare worker mandates at federally funded facilities are within federal authority.
Clarified the scope of federal executive authority to mandate vaccination, distinguishing between sector-specific mandates (permissible) and general public health mandates (beyond OSHA's authority).