In a widely circulated image, a little girl asks her mother about the mark on her arm. She is told it’s her mother’s smallpox vaccination scar, the daughter asks: “Why don’t I have any? “ The answer: “Because it worked. “

Pandemics are devastating, disrupting business, education and government. They kill hundreds of thousands of people and sometimes leave survivors with lifelong problems. The plague of Athens in 430 BC killed a quarter of the population, destroying the city’s culture and democracy. Justinian’s plague killed half the world’s population in 541. Eight centuries later, the same germ transmitted by fleas caused the “Black Death” in Europe, killing some 50 million people.

The first vaccine, in 1796, used an animal virus (smallpox) to create immunity against the human smallpox virus. Before that, people were inoculated with material from wounds or scabs of infected patients. The procedure was risky but it reduced smallpox deaths from 30 percent to less than 2 percent. George Washington, with the blessing of the Continental Congress, ordered smallpox for all recruits, so that in the fall of 1776 his healthy army was able to defeat the British invaders of General Burgoyne. American independence owes its existence, in part, to compulsory vaccination.

Massachusetts passed the first US vaccination law in 1809, requiring the general population to be immunized against smallpox. Boston, in 1827, became the first American city to frequently require smallpox vaccination for schoolchildren. There was strong opposition to the application of these laws across the country. Some states have repealed vaccination laws. The Anti-Vaccination Society of America was formed in 1879. A York, Pennsylvania newspaper in 1906 reported threats to burn schools and whip teachers in response to the vaccination requirement. Just about every vaccination requirement over the years has met some level of resistance.

But history shows the effectiveness of mandatory vaccines. Watch the incredible reduction in mortality with all childhood vaccines developed in the 20th century. Mandatory vaccinations for children have extended life expectancy by decades for the generations of our parents and grandparents, and they continue to benefit everyone.

The effectiveness of public health measures such as the closure of businesses and schools, isolation, contact tracing and masking were established during the 1918 pandemic. Cities that quickly implemented such measures fared better than those who reacted more slowly. But these measures have also encountered resistance and non-compliance. In San Francisco, a 1918 ordinance requiring everyone to wear a mask in public was lifted as the crisis appeared to be over. When cases rose again, the city reinstated the ordinance, prompting organized protests and the formation of a “Anti-mask League”.

The COVID-19 pandemic ebbed in 2021 as more people were getting vaccinated. Unfortunately, vaccinations stalled long before they achieved collective immunity and businesses reopened, activities such as sporting events resumed and, perhaps more importantly, schools reopened in person. These factors, along with the decrease in immunity in some vaccinated people, gave the more contagious Delta variant the opportunity to bring the pandemic back to full force.

The response to the current COVID crisis announced by President Biden on September 9 has multiple mandates. These include requiring employers with 100 or more employees to ensure their employees are vaccinated or tested weekly, and requiring vaccinations for all federal employees and contractors, all workers. health workers in hospitals and other facilities participating in Medicare and Medicaid; and all staff at Head Start Programs, Department of Defense Schools and Office of Indian Education Managed Schools.

On August 31, the PA Ministry of Health issued an order requiring every teacher, child / student, staff member or visitor working, attending or visiting a public or private school to wear a mask indoors, regardless of their vaccination status.

The perpetual tension between civil liberties and government authority manifests itself as governments attempt to stop pandemics. As in the past, these mandates have given rise to discussions, disagreements and, in some cases, strong resistance or even non-compliance.

Mandates relating to vaccines are constitutional. The Supreme Court ruled in 1905 (Jacobson v. Massachusetts) that governments have the power to impose vaccinations. In 1922 (Zucht v. King), the Court upheld the vaccination requirements in schools. There are questions about the power of the federal government to impose vaccinations and other measures and whether vaccines under emergency use authorization should be mandatory. The courts will eventually decide this, but we need to get COVID-19 under control now. Certainly, unprecedented circumstances justify unprecedented solutions.

In its 1905 decision, the Supreme Court wrote: “The freedom guaranteed by the Constitution of the United States to all persons under its jurisdiction does not imply an absolute right of each person to be, at all times and under all circumstances, entirely free from all coercion. There are multiple constraints to which each person is necessarily subject for the common good. On no other basis could organized society exist with the security of its members. “

It is as true today as it was then: we are all in the same boat.

Michael Heyd, a retired Fairfield Township medical librarian who has spent more than 40 years researching the literature for professional hospital staff, is a member of Let’s End COVID !, a Northcentral PA stakeholder group that works overcome the COVID-19 pandemic through education, awareness and mitigation.

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