What's the most extreme way the states of the United States can insure compliance to a vaccine mandate for all adults?


Jacobson v. Massachusetts, 197 U.S. 11 (1905), was a United States Supreme Court case in which the Court upheld the authority of states to enforce compulsory vaccination laws. The Court's decision articulated the view that individual liberty is not absolute and is subject to the police power of the state.

Recently, there was a lot of discussions about a possible vaccine mandate and pundits have referred to the Supreme Court case above to make the case that a vaccine mandate in some states would be possible.

There's not a point of common intersection for adults with the state or an agency thereof as there is for children as they all go to school or at least the majority of them. Because of that it's not clear how states can work into a mandate a way to insure compliance, so my question is: what's the most extreme way the states of the United States can insure compliance to a vaccine mandate for all adults?

  • 1
    All adults? That is not medically advisable. There are some adults who should not be vaccinated. This is a very tiny fraction of the adult population. That said, the US is nowhere close to that limit right now. "I am extremely stupid" does not qualify as a reason for not getting vaccinated. Commented Aug 8, 2021 at 20:51
  • Could the Supreme Court strip a citizen of their US citizenship for non-compliance? That would be extreme.
    – Criggie
    Commented Aug 8, 2021 at 22:06
  • 2
    What do you mean by “most extreme?” Are you really asking for the most effective way to accomplish this, assuming no one cares about politics or rights? Or is this an imagination question, like if the child of Hitler and the Devil was in charge, how could they push vaccination in the most extreme and evil way?
    – divibisan
    Commented Aug 8, 2021 at 22:44
  • Fine the person $200 (equivalent to the $5 fine in 1905 per the linked article) on each occasion he refuses to be vaccinated. Or more extreme, keep him in isolation until the pandemic is over, or he agrees to be vaccinated, whichever comes first. :)
    – r13
    Commented Aug 9, 2021 at 23:21

2 Answers 2


In Jacobson v. Massachusetts, the city of Cambridge was empowered by state law to require vaccinations. It did so, and the Supreme Court upheld the requirement. Therefore any state, simply by passing appropriate legislation, can require everyone to get a covid vaccine. As in the Jacobson case, this could be enforced by fines or imprisonment. Your question seems to be a purely theoretical one, since nobody is seriously proposing such a mandate in the US, but theoretically the police could go from door to door arresting people who couldn't show proof of vaccination.

  • Could the state just vaccinate people on the spot when caught instead of penalizing them? Commented Aug 8, 2021 at 14:45
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    @JonathanReez Extremely unwise. What if the person who didn't show proof of vaccination at their door was someone for whom the vaccine is medically dangerous? Are you even certain of their identity? You'll need to keep track of it to know who needs a second dose a few weeks later, but how do you do that at the doorstep if they don't produce any ID (you don't know if they can't or are refusing to). To forcibly vaccinate people you'd really need to arrest them and do a lot of paperwork and checking up with their claimed doctors, not just have door knockers with needles.
    – Ben
    Commented Aug 8, 2021 at 21:30
  • It might be a bad idea but could the state say “f- it” and just do it legally speaking? Commented Aug 8, 2021 at 21:36
  • @JonathanReez if the state can imprison people, they basically are saying "you will not get out of jail until you are vaccinated." So the state may afford the luxury of waiting until they have all the data they require to ensure that it is safe to vaccine the individual, they do not need to rush.
    – SJuan76
    Commented Aug 11, 2021 at 12:19

The case in Jacobson doesn't specify exactly how the prosecutor knew Jacobson was not vaccinated, but it's not hard to imagine that the state could start with the records it has of its citizens and require them to provide proof of vaccination and go after those that don't. In Jacobson, a criminal complaint was filed and adjudicated in court, so the normal court procedure would either force a defendant to get vaccinated to avoid punishment, or criminally punish them as with any other convicted person.

While with a usual criminal procedure the police would not be specially authorized to detain people without reasonable suspicion or conduct home searches without a warrant and medical procedures are a ultimately a person's decision, the subject matter of Jacobson drives the Court into such a deference to legislature that they've used it to justify forcibly sterilizing women based on their "feeble-mindedness" and I have no doubt they will continue the historical precedent of accepting whatever the "medical community" convinces the legislature is necessary. So, with that said, it's hard to say what the Court would authorize as a necessary break from normal expectations of rights, perhaps unvaccinated people must be so crazy that it would be justified to keep them in detention until they agree to vaccination, or skip all that and force convicted persons to be vaccinated regardless of what the person's wishes are.

  • 3
    -1 for all the drama and neglecting the fact that decisions not to vaccinate put other people at risk. Stick to arguments concerning vaccine related facts, including against mandatory vaccinations and even things like medical risks, don't bring in totally unrelated stuff like Nazis. There are plenty of subjects on which the state compels adults to act against their free will, even if medical subjects should be one of the last in which it should considered. Commented Aug 8, 2021 at 17:44
  • @ItalianPhilosophers4Monica The question was what measures can legally be taken to effect a mandate, my answer is that SCOTUS has shown willingness to authorize indefinite detention (e.g. Korematsu) and forced medical procedures in the past on arguably shakier grounds so there's no reason to believe they won't now if that's what the legislature passed. I've removed some of the more colorful language though. Commented Aug 8, 2021 at 18:32

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