Brooklyn's Epidemic Battle: Can It Mandate Vaccinations?

In 2019, a measles outbreak in Brooklyn, New York City, led to a mandate requiring people in the affected areas to get the vaccine or face fines. This raised the question of whether such a mandate was legal and ethical. While forced vaccination is rare and considered an intrusion on liberty, it has been upheld by the courts in the past. The Supreme Court has recognized each state's police power, which gives them the authority to enact health laws, including vaccination laws, to protect its citizens. In the case of the Brooklyn measles outbreak, a judge upheld the mandatory vaccination order, dismissing a lawsuit from parents who claimed the city had overstepped its authority.

Mandatory vaccination laws in Brooklyn

In 2019, New York City Mayor Bill de Blasio declared a public health emergency in parts of Brooklyn in response to a measles outbreak. The declaration required unvaccinated people living in the affected areas to get the vaccine or face fines of $1,000. This mandate was upheld by a Brooklyn judge, who dismissed a lawsuit from a group of parents who claimed that the city had overstepped its authority.

The United States Supreme Court has long recognized each state’s “police power,” which gives states the authority to enact health laws, including quarantine and vaccination laws, to protect their citizens. The Court ruled over a century ago that mandatory vaccination was legal, although it drew a distinction between punishing citizens for refusing vaccination and actually vaccinating them by force. While courts have allowed health officials to fine citizens for refusing vaccination, forced vaccinations are highly unusual and may be unconstitutional intrusions on liberty.

In the case of the 2019 measles outbreak in Brooklyn, the mandatory vaccination order was imposed by the city's Board of Health, which voted to extend the mandate until the end of the outbreak. The purpose of the emergency order was not to fine people, but to stress the urgency and importance of getting vaccinated. The New York Department of Health had recorded 359 cases of measles since the outbreak began in October 2019, with the Williamsburg section of Brooklyn at its epicenter.

While mandatory vaccination laws can be controversial, with some arguing that they infringe on individual liberties, it is clear that states have the power to enact such laws in the interest of public health and safety. This power is derived from the state’s “police power,” which has been upheld by the Supreme Court. Additionally, the 14th Amendment right to liberty is not violated by mandatory vaccination laws, as they fall within the many restraints to which every person is necessarily subjected for the common good.

The role of the courts

In the case of an epidemic, the role of the courts is complex and multifaceted. While the courts generally uphold the importance of individual rights and liberties, they also recognize the need to protect public health and safety. This often results in a delicate balance between individual freedoms and the greater good of society.

In the context of vaccination laws, the courts have historically deferred to the state's "police power," which grants states the authority to enact health laws, including quarantine and vaccination mandates, to safeguard their citizens. This power is derived from the concept of public health and safety, and it substantially influences the court's decisions.

The Supreme Court has played a pivotal role in shaping vaccination policies. In the landmark case of Jacobson v. Massachusetts in 1905, the Court affirmed that mandatory vaccinations were within the state's police power and did not violate the 14th Amendment right to liberty. This precedent has guided subsequent court decisions, where judges have upheld mandatory vaccinations during outbreaks, such as the measles outbreak in Brooklyn, despite legal challenges from parents.

However, the courts also recognize the importance of individual rights, including bodily integrity and parental control. In certain instances, such as the North Carolina Supreme Court ruling, families have been allowed to sue over vaccinations administered without consent. The court asserted that constitutional rights, such as bodily integrity, take precedence over immunity granted by laws like the PREP Act.

Additionally, the courts have weighed in on vaccination mandates for specific groups, such as healthcare workers. The Supreme Court upheld a vaccination mandate by the Centers for Medicare and Medicaid Services for healthcare workers at federally funded facilities, recognizing the importance of protecting patients and medical staff.

In summary, the role of the courts in vaccination laws during an epidemic involves navigating the complex balance between individual rights and public health needs. While generally deferring to the state's police power, the courts also scrutinize cases involving consent, constitutional rights, and the scope of authority of federal agencies.

Religious objections

In the case of an epidemic, Brooklyn can mandate vaccination laws, as demonstrated by the 2019 case in which a Brooklyn judge upheld mandatory measles vaccinations, dismissing a lawsuit from parents who claimed the city had overstepped its authority. The Supreme Court has recognised each state's "police power", which gives states the authority to enact health laws, including vaccination laws, to protect their citizens. This power is not considered to violate the 14th Amendment right to liberty.

Despite the legal mandate for vaccinations during an epidemic, religious objections have been raised as a concern. The First Amendment of the US Constitution protects religious freedom, and states can only abridge religious practices when there is a compelling interest and the law is substantially related to protecting this interest.

While some religious groups have objected to vaccinations on theological grounds, it is difficult to find a major religion that explicitly objects to immunisation. The world's major faiths, including Buddhism, Christianity, Hinduism, Judaism, and Islam, do not have explicit prohibitions against vaccines. However, there are smaller religious groups, such as the New Jersey-based Congregation of Universal Wisdom, that explicitly forbid vaccinations, surgeries, and medicine, classifying them as "sacrilege".

During the COVID-19 pandemic, the issue of religious objections to vaccination mandates became more prominent, with courts limiting the federal government's ability to impose mandates and questioning the need for states to grant religious exemptions. The Supreme Court's decision in Groff v. DeJoy concerning Title VII of the Civil Rights Act of 1964 also raised questions about the ability of private employers, including healthcare organisations, to enforce vaccination requirements for employees with religious objections.

While some employers have allowed exemptions for those with religious objections, public opinion is divided. According to a Pew Research Center survey, two-thirds of US adults believe that most people claiming religious objections are using religion as an excuse to avoid vaccination. However, a majority of adults (65%) think that employers requiring coronavirus vaccinations should allow religious objectors to keep their jobs.

In conclusion, while Brooklyn can legally mandate vaccinations in the case of an epidemic, religious objections have been raised, and the balance between public health and religious freedom remains a complex and ongoing discussion.

Public health powers of the state

In the United States, states are the principal governmental entity responsible for protecting the public's health. They conduct a wide range of activities in health, including collecting and analyzing information, conducting inspections, planning, setting policies and standards, carrying out national and state mandates, and managing and overseeing environmental, educational, and personal health services.

State health agencies derive their power from the state's "police power," which gives the state authority to enact health laws, including quarantine and vaccination laws, to protect its citizens. The Supreme Court has upheld this power, ruling that it does not violate the 14th Amendment right to liberty. The courts do not interfere with legislation formed under the state's police power as long as it relates substantially to public health, morals, or safety and does not plainly invade rights secured by fundamental law.

During declared emergencies, state and federal authorities have broader powers to act, including the ability to suspend or modify legal requirements, pass and enforce laws, and expend funds for the health and safety of the public. In the context of an epidemic, states have the power to mandate vaccinations as a reasonable exercise of their police power to protect public health and safety. For example, in 2019, a Brooklyn judge upheld a mandatory measles vaccination order, dismissing a lawsuit from parents who claimed the city had overstepped its authority.

However, in the context of the COVID-19 pandemic, there has been a pushback against public health powers in many states. Republican legislators in more than half of the states have passed laws to curb the powers of state and local officials to protect the public against infectious diseases. At least 16 states have limited the power of public health officials to order mask mandates, quarantines, or isolations, and at least 17 states have passed laws banning COVID-19 vaccine mandates or making it easier to get around vaccine requirements. These actions have been criticized by public health academics and officials, who argue that they will have consequences that last beyond the current pandemic and hinder their ability to fight future disease outbreaks.

The right to refuse

In the case of an epidemic, the right to refuse vaccination is a complex issue that involves individual liberties, public health, and state powers. While some people may argue for their right to refuse vaccination, public health authorities and legal precedents often lean towards mandatory vaccination to protect the broader community.

The 14th Amendment of the US Constitution protects citizens' liberties and due process rights, guaranteeing that legislation must be substantially related to a legitimate government purpose. However, the Supreme Court has also recognized each state's "police power," which grants them the authority to enact health laws, including vaccination mandates, to safeguard public health and safety. This power is derived from the precedent set in Jacobson v. Massachusetts in 1905, where the Court ruled that mandatory vaccinations for smallpox were within the state's police power and did not violate the 14th Amendment.

While individuals may have personal beliefs or religious objections to vaccination, these rights are often outweighed by the state's compelling interest in protecting public health. The effectiveness of the vaccine itself is not the determining factor; instead, it is the state's belief in the vaccine's potential to promote the common welfare that matters. This principle is exemplified in the case of Washington state, which removed the personal belief exemption from MMR vaccinations during a measles outbreak.

To protect their citizens' health and medical freedom, several states have introduced "Right to Refuse" laws and bills. As of 2024, over 100 new Right to Refuse bills have been filed, and twenty-nine states have passed 75 Right to Refuse bills into law. These laws aim to defend individuals' ability to choose whether to receive a vaccine or submit to other medical interventions.

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