Have Vaccines Ever Been Mandated in History? Biden COVID Shot Plans Could Affect 100m People

In order to tackle the spread of COVID in the U.S., President Joe Biden made a U-turn on mandatory vaccination on Thursday when he announced that all federal employees must be vaccinated over the coming months or their jobs may be at risk.

The mandate could potentially affect up to 100 million Americans. Employers with more than 100 employees must ensure their workers are vaccinated or tested weekly, while federal contractors must be vaccinated. The move reflects measures employed in California and New York.

The U.S. is no stranger to protecting the health of Americans through mandatory vaccination. In 1901, the target of vaccination wasn't COVID but smallpox. The highly contagious virus, estimated to have killed 300 million people in the 20th century, caused fevers and a severe rash on the arms and face that often left survivors scarred for life.

At the turn of the 20th Century, three out of 10 people that contracted smallpox died as a result of the virus. This mortality rate led to 270 deaths in Boston alone during an outbreak that lasted from 1901 to 1903.

In Cambridge, a city next to Boston, a smallpox panic forced the closure of schools, libraries, and churches in scenes that would have resembled lockdowns imposed by COVID 120 years later. This spurred public health officials in the city and its neighbors to introduce a mandatory vaccination against smallpox.

A $5 fine was introduced in the city for citizens who refused to be vaccinated. The move was challenged in Massachusetts' courts, with the highest court in the state backing Boston public health officials in the 1905 case Jacobson v. Massachusetts.

The Supreme Court ruled mandatory vaccination in the state did not violate the first amendment. While acknowledging the personal freedom of U.S citizens, Judge Justice John Marshall Harlan said in an opinion at the time that "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."

Smallpox vaccination
A printed smallpox vaccine certificate, filled out with ink by United States Marine Hospital Service dating back to 1902. Boston health officials introduced a vaccine mandate at the start of the 1900s to combat a devastating smallpox outbreak. Photo by The New York Historical Society/Getty Images/Getty

The U.S. military also has a long history of mandating vaccines. The Department of Defense requires mandatory vaccination for U.S. military personnel in the Air Force, Army, and Navy. The program includes 17 different vaccines, with the COVID shot added in August.

From 1812 to the start of World War II 1939, American soldiers were vaccinated against smallpox, with vaccines for flu, tetanus, cholera, and other viruses added during the conflict.

In 1777, during the Revolutionary War and following the Declaration of Independence, smallpox was killing around one in three Americans who contracted it, and military camps were one of the places it seemed to break out frequently.

Though the science behind smallpox and other viruses was still poorly understood in the 18th Century, General George Washington recognized the damage that could be inflicted by the spread of smallpox and that infections seemed to break out in crowded areas.

A rudimentary vaccine had been used by doctors in Massachusetts in the 1720s and figures including Benjamin Franklin, Thomas Jefferson, and Martha Washington were vaccinated against smallpox.

Even though the vaccination resulted in the recipient suffering from lesser symptoms of smallpox should they catch it, the general feeling was that the inoculation had actually helped spread the virus.

As a result of this assumption, Congress banned vaccines in 1776. That means Washington's move to bring the vaccine back in February of the following year was considered a drastic move.

In a February 1777 letter to John Hancock, Washington announced his plan to innoculate troops as fast as they came into Philadelphia if they had not suffered from smallpox in the past. State conventions were also asked to vaccinate troops before they were sent to winter quarters.

Unlike Biden, Washington kept the vaccination mandate secret as he feared that if the British learned swathes of the Contentinal army were recovering from the inoculation, they would seize the opportunity to strike. Just as the Continental army eventually turned back the threat of the British, vaccination would too conquer smallpox.

In 1980 the World Health Assembly announced that smallpox had been eradicated globally. The eradication was directly tied to the deployment of vaccines against the virus and it has since been considered one of the biggest achievements of international public health.

history vaccine mandate
An image showing General George Washington (center) leading the Continental Army in the Battle of Princeton during the American Revolutionary War, January 3, 1777. Washington secretly introduced a vaccine mandate to troops. Stock Montage/Getty Images