What does choice mean for vaccinations?
Niran Al-Agba  Columnist  Medicine and jurisprudence intersect inside the hallowed halls of the Supreme Court, which is the last stop for those seeking justice and equality. In my opinion, the government does not belong in my body, my bedroom, or on my deathbed. Medical decisions belong in the hands of patients, and if necessary, in consultation with their physician. In my previous column I discussed how the U.S. Supreme Court relied on the right to privacy guarantee in the 14th Amendment to uphold abortion rights in the landmark Roe v. Wade decision. While many have strong opinions on abortion, to me, the looming Mississippi abortion case is about far more than one medical intervention  it is about choice; something I want to explore from different perspectives. This week, I want to examine the growing debate about compulsory COVID-19 vaccination. In December 2020, the Food and Drug Administration issued the first emergency use authorization (EUA) for a vaccine to prevent coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2. The vaccination is safe. As of this week, two-thirds of U.S. adults, 162 million people, have had at least one dose. It is also proving effective  97% of the new COVID-19 cases in King County are in unvaccinated people. More in this series:Why Supreme Court's abortion case may also weigh your privacy  Houston Methodist Hospital, a not-for-profit 907-bed facility in Texas, is the first healthcare system in the U.S. to mandate employees get vaccinated against COVID-19. If they do not comply, employees will face suspension and possible termination. One hundred and seventeen Houston Methodist employees filed a lawsuit objecting to the mandate, arguing that the requirement violates the Nuremberg code, a World War II-era ethics guide designed to prohibit medical experimentation on unwilling participants. Last Monday, U.S. District Judge Lynn Hughes denied the plaintiffs request for an injunction to block Methodist Hospital from suspending them. Hughes, a Reagan appointee, found protecting the publics access to safe healthcare during a pandemic outweighed the vaccination preferences of employees. All Houston Methodist employees who did not receive the first dose by Tuesday, June 8 were placed on a two-week unpaid suspension. If not vaccinated by June 21, Houston Methodist says it will fire them. For the liberal-leaning folks, this is a win for science and a win for the nation. The Court last ruled on a vaccination mandate law for adults in 1905, more than a century ago. In May 1901, smallpox was spreading rapidly across Boston. The case fatality rate for unvaccinated people was double the rate of those who were vaccinated. Dr. Samuel Holmes, a Harvard-educated physician and chairman of the Boston Board of Health, implemented a program of thorough disinfection, vaccination, and re-vaccination of all ill contacts. By the end of 1901, 400,000 Bostonians had been vaccinated, yet the epidemic raged on despite containment efforts. In 1902, the Board of Health ordered all the inhabitants of this city who have not been successfully vaccinated since 1897, must be vaccinated or revaccinated. Vaccination refusers were subject to a $5 fine (about $100 today) or a 15-day jail sentence. Although generally safe, smallpox vaccination was not without risk, including ulceration at the inoculation site, infection, and even death. The Rev. Henning Jacobson, a charismatic preacher and community leader, refused to be vaccinated and was fined. Alleging the vaccination law was a violation of due process under the 14th Amendment and his right to live and work where he will, Jacobson refused to pay the fine. He argued for the inherent right of every free man to care for his own body and health in such a way as to him seems best. After the local and state courts upheld the fine, Jacobson appealed to the Supreme Court. In a 7-2 decision, the Supreme Court ruled the Massachusetts law mandating smallpox vaccination was constitutional. While the 14th Amendment protects individual liberty, the Court held that restricting merely one aspect of that liberty  vaccine refusal  was justified in the name of public health and safety. As the first case regarding a vaccine mandate by a private company, employment lawyers are watching the Houston Methodist case very closely. We should all be watching. Plaintiff Jennifer Bridges said, They [Houston Methodist] need to give people choices. While many see Judge Hughes decision as a victory in the war against COVID-19, too few realize where a decision like this may lead. We need to think about this carefully. Choice doesnt care about your personal ideology. As you will learn more about in my next column, an era of less medical choice resulted in one of the most reprehensible rulings ever handed down by the Court in history. Dr. Niran Al-Agba is a pediatrician in Silverdale and writes a regular column for the Kitsap Sun. Contact her at niranalagba@gmail.com.