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1 1 (May 22, 2019)

handle is hein.crs/govzuv0001 and id is 1 raw text is: Con gressional _______ * Research Service .... .. nformrng the Iegislative debate since 1914 An Overview of State and Federal Authority to Impose Vaccination Requirements May 22, 2019 According to the latest available data from the Centers for Disease Control and Protection (CDC), 7 states in the United States are currently in the midst of 10 separate measles outbreaks. With 880 total confirmed cases so far this year, 2019 now has the greatest number of reported cases of measles since 1994 and since measles was declared eliminated in the United States in 2000. These cases, the majority of which involves unvaccinated individuals, follows a number of notable measles outbreaks over the past several years, including an outbreak of 383 cases in 2014 among unvaccinated Amish communities in Ohio and another multi-state outbreak of 147 cases in 2015 linked to an amusement park in California. In addition to measles, for about every 5 years since 2006, outbreaks of other vaccine-preventable diseases, such as mumps, have also been reported in the United States. In light of these outbreaks and their association with unvaccinated individuals, this Sidebar provides an overview of the relevant state and federal authority to require vaccination for U.S. residents. State and Local Authority Over Vaccination Under the federalist system of the United States, state governments have the general authority, within constitutional limits, to enact laws to provide for the public health, safety, and morals of the states' inhabitants. In contrast to this general police power, as discussed below, Congress's power to legislate is confined to those powers enumerated in the Constitution. The states' general police power to promote public health and safety encompasses the authority to require mandatory vaccinations. Pursuant to this authority, states and localities have long enacted various compulsory vaccination laws for certain populations and circumstances, including for school children and certain health care workers and in cases of public health emergency. In the early part of the 20th Century, the Supreme Court twice considered constitutional challenges to such mandatory vaccination requirements. Each time, the Court rejected the challenges and recognized such laws to fall squarely within the states' police power. In 1905, the Supreme Court in Jacobson v. Commonwealth of Massachusetts upheld a state law that gave municipal boards of health the authority to require the vaccination of persons over the age of 21 against smallpox, determining that the vaccination program had a real and substantial relation to the protection of the public health and safety. In doing so, the Court rejected the argument that such a program violated a liberty interest that, under more modem Congressional Research Service https://crsreports.congress.gov LSB10300 CRS Legal Sidebar Prepared for Members and Committees of Congress

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