As far as I know, vaccinations for smallpox, measles, polio, etc. have all been voluntary, unless people were ordered to get vaccinated by their employers or possibly the military.

Has the U.S. government ordered U.S. citizens to get vaccinated before the coronavirus situation?

I found one statement that is confusing:

There is no Federal requirement for informed consent relating to immunization. 1

Does that mean what it literally says - that the government can mandate that citizens be vaccinated without their consent or, apparently, even without their knowledge? Or am I misreading it?

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    Variola Vera was mandatory. There's a SCOTUS case about it: Jacobson v. Massachusetts
    – Trish
    Aug 12 at 10:22
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    The US Federal Govt has not AFAIK, mandated any vaccinations. Various state and local mandates have been in force at various times. The statement about informed consent is translating from federal law dealing with human research, which does not really apply;y in this context. State laws on medical practice generally mandate informed consent for any treatmet6n. Aug 23 at 19:41
  • @Trish most English speakers, or at least most Americans, have no idea what variola vera is. The English word is "smallpox." (Furthermore, the disease wasn't mandatory, only the vaccine was.)
    – phoog
    Aug 23 at 21:10
  • until recently, Americans just all got vaccines, at least the ones that matter. It is our rather recent stupidity, reinforced by social media, that has changed this.
    – Tiger Guy
    Aug 23 at 21:37
  • @Tiger Guy After Jacobson vs Massachusetts in the early 1900s, a number of vocal anti-vaccination organizations forms and were for a tiem rather influential. See the Wikipedia article on the case. So the current popularity of anti-vaccine views is not the first in US history. Sep 10 at 1:45

If there is a universal vaccination mandate by any government anywhere in the US, I would like to know about it. Mandates apply to specific groups and frequently allow exceptions.

There is no general purpose federal law that mandates any vaccination for everyone. Federal law might mandate vaccination for specific people, eg, new immigrants, military, employees, prisoners, or people in some form of custody, such as some undocumented immigrants.

All general purpose vaccine mandates come from state or local governments or employers or other agencies, such as concert venues.

The Supreme Court case on vaccine mandates is about a local area where there was a smallpox outbreak. That vaccine was mandated by either state or local law. Smallpox is dangerous, readily transmitted, and the Supreme Court decided that vaccination could be mandated in such circumstances.

The following may come as a surprise to many readers. Public health is a state or local affair. Federal agencies do not manage public health except at the invitation of a local government. The Federal Government is actually a shrinking violet in matters of public health, except for spending money.

Public health agencies are reluctant to mandate universal vaccinations and, except for outbreaks in local area, have not done so. (We currently have an outbreak of a dangerous, disabling, expensive-to-treat, and fatal disease in every state, locality, and territory. Vaccines have been approved for it.)

Public health law often requires that schoolchildren have a standard series of vaccination and these can usually be obtained from the local health department. There are usually some allowable exceptions, even for these. And, of course, children do not all go to school.

Federal agencies do a lot of other things, eg, research on diseases, investigate outbreaks in conjunction with local public health officers and agencies, regulate food, drugs, devices, and cosmetics in interstate commerce, regulate international borders, pay for much of the state and local public health services, etc.

The Federal government also provides compensation for immunizations that caused injury or damage through a fund. Someone who has been injured must first seek compensation from this fund before suing a manufacturer. The legal standards to obtain compensation are lower than those for a lawsuit so there are nearly no lawsuits for injury due to vaccination.

If you got the vaccination for Covid-19 then you received information about the specific vaccine you got and you signed to give your consent to receive it. This is informed consent. You probably did this if you had surgery or major medical therapy or if you participated in research. You even did this if you participated in a Federal or State sponsored survey interview. If you did this for surgery it wasn't required by the Federal government only by the surgeon and hospital where you were treated.

Added September 9, 2021:

President Biden issued a "Path out of the pandemic" today, available at https://www.whitehouse.gov/covidplan/.

This greatly extends Federal influence on vaccination programs. It mandates vaccination or frequent testing of several groups: employees of companies who have at least 100 employees (using an OSHA Emergency Temporary Standard), Federal employees, employees of companies with Federal contracts, and virtually all employers who receive Medicare and Medicaid funds (under a Center for Medicare and Medicaid Services regulation).

These mandates will come from different agencies, OSHA and CMS, that is, there is no single mandate. They are connected to health and safety or Federal contracting. Some employers will be covered more than once, eg, hospitals with more than 100 employees that receive Medicare payments and contract to provide services to specific Federal agencies. These mandates are far from universal since they only apply to employees, no one else. At least some of the mandates permit regular and frequent testing instead of vaccination and allow medical and religious exemptions to vaccination.

It seems likely that these mandates, applied only to employers, might be about as far as Federal regulations can go.


There is no Federal requirement for informed consent relating to immunization.

Does that mean what it literally says - that the government can mandate that citizens be vaccinated without their consent or, apparently, even without their knowledge? Or am I misreading it?

You're misreading it.

It does mean literally what it says, but it does not literally say that the government can mandate that citizens be vaccinated without their consent or knowledge. Rather, it literally says that there is no federal requirement for informed consent relating to immunization.

This simply means that someone vaccinating you without your consent (or with improperly obtained consent) is not violating federal law. It doesn't mean that states cannot impose a requirement for informed consent, however, and it certainly does not imply that the federal government can mandate anything.

Saying that federal law doesn't require something is not at all the same as saying that federal law can require something else. For example, there is similarly no federal requirement for informed consent in connection with the purchase and consumption of ham sandwiches at my corner deli, but that doesn't mean that the federal government can enact a law requiring me to buy and consume a ham sandwich.


To the best of my knowledge, there is not now and never has been a federal law mandating vaccination for any disease.

There have been local laws enforcing quarantines and vaccination regimes for various diseases. These were authorized by state law, as i understand it. The regulation mandating vaccination for smallpox that was upheld in Jacobson vs Massachusetts was such a local rule, permitted by a state law. I think there have been a few state laws mandating vaccination in particular circumstances, although none that I know of mandating vaccination for all or most residents. Such laws would be constitutional under Jacobson vs Massachusetts (assuming the court did not overrule itself). Whether they would be good policy or politically feasible is a very different question.

State laws or local regulations mandating vaccinations now would need to have exemptions for people medically unable to tolerate vaccinations, or at much higher than normal risk from vaccinations. Indeed the local regulation at issue in Jacobson vs Massachusetts had such an exemption. (It applied only to people "fit for vaccination" as determined by a doctor.) Any such mandates would probably require a religious exemption as well, under current federal law and current case law on regulations affecting religious practice.

Various US states now have laws mandating particular vaccinations for children attending public schools (and in some cases private schools as well). These have various exemptions. The Supreme Court has upheld such laws as constitutional in Zucht v. King 260 U.S. 174 (1922). (That case dealt with a mandate that covered both public and private schools.) Vaccinations for COVID-19 could be added to such lists, and there would be no constitutional problem with doing so. Policy and politics, again, are a different issue.

Thew Federal EEOC has said that private employers may mandate vaccinations for those entering a workplace, subject to the need for reasonable accommodations for those who validly request accommodation. I am not aware of a court ruling at any level on this issue.

The Federal Government might well have constitutional power to demand vaccinations for people entering the country, or traveling from one state to another, under its power to regulate "foreign and interstate commerce". I am not aware of any serious proposal to pass such a law.

But the current constitutional position is clear: under Jacobson vs Massachusetts states or localities (with state authority) may impose mandatory vaccinations as they consider appropriate. Requirements for medical or religious exemptions have not been specifically tested in a vaccination context, as far as I know, but given the cases establishing the need for such exemptions in other contexts, they would probably be essential. Federal power to impose mandatory vaccination is untested, but probably extends at least as far as the commerce clause power of Congress.


"Informed consent" means not only that you must consent, but that the party seeking your participation has to satisfy various requirements pertaining to explaining the risks in participation (and possibly other things). Here is a detailed FAQ on general informed consent (federal law) from Health and Human Services. This is about research participants.

When you get a vaccination from a pharmacy or doctor, this is not within the scope of the research-related federal laws (which were passed in response to the Tuskegee study). So the consent laws that pertain to getting an ordinary vaccination are not federal: consent is a matter of state law. Consent is required at the state level. Here is a long article on general medical informed consent law, which focuses on standard risks for medical procedures – if there's a 33% chance of dying from a certain surgery, the doctor has to inform you of that fact. Under no circumstance that the government use direct force to vaccinate you. At most, they could penalize you or in some way restrict you for violating a mandatory vaccination law (but there is no such law). So consent is never optional, the only question is whether the healthcare provider gave you sufficient information to make a reasoned choice.


There is no Federal requirement for informed consent relating to immunization.

is also a positive expression: It says that immunization does not (always) require informed consent.

Some vaccinations, as well as other medical treatment, may be applied without consent. For instance, a Tetanus vaccine may be injected to a patient after an accident, even if he/she is unconscious. Other medications may be used in this case as well without the explicit consent of the patient.

I would definitely call this a good thing. Imagine that treatment of a patient after an accident or a heart attack is only possible if he gives an explicit consent, ideally in three written copies...


Given that participation in the military was compulsory at one point in the US (1940-1973) albeit based on army needs, and also during several more wars, your caveat about the military clearly doesn't hold water historically. E.g.

Because of both direct and indirect benefits, most US military immunizations are required, rather than voluntary. Figures 1, 2, and 3 illustrate the records used to document immunizations of troops during World War II.

I'm not sure what was done to/with conscientious objectors (COs) in this regard. The article doesn't discuss that but does say:

Vocal objection to military immunization programs occurred with variolation in the 1770s, smallpox and typhoid vaccines in the 1910s, various vaccines in World War II, and anthrax vaccine in the 1990s.

There are more in-depth articles on COs and vaccination, but upon quick skimming it's hard to say what the rules in the US were.

However, simply focusing on the lack of a universal federal mandate is somewhat shortsighted, because e.g.

all 50 states require some vaccines for children attending public schools, with exceptions for those with disabilities or with religious, philosophical or medical objections.

The precise grounds for exemption varies from state to state, so it's too much to discuss here.

These state-level efforts have been pretty successful, e.g. 90% or so of US children are vaccinated against measles. So it's not too clear why the federal government would want to bother passing some federal mandate laws on something like that, on top of those of the states.

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