The Atlantic suggests this analogy-of-sorts regarding Texas' recent S.B.8 law, limiting abortions by allowing private citizens to sue providers to enforce the law's mandate:

Imagine if Massachusetts had mandated vaccines for those with bona fide religious objections and allowed private citizens to use litigation to enforce that decree.

Does this putative law giving citizens the ability to enforce a vaccine mandate via lawsuits have a reasonable prospect of being just as difficult to challenge as SB.8... or even harder perhaps, since a vaccine "refusenik" potentially poses a community health risk more easy to quantify than someone having an abortion?

Or would it, in contrast, be much easier to challenge, because it would impose a treatment on someone who has religious objections, as opposed to forbid a treatment/intervention?

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    Massachusetts could just directly impose a vaccine mandate with no religious exemption. The Constitution does not require religious exemptions from neutral laws of general applicability (Employment Division v. Smith).
    – cpast
    Sep 4, 2021 at 0:07
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    @cpast: that seems correct, although apparently it was last test in the Supreme Court 101 years ago supreme.justia.com/cases/federal/us/260/174 Sep 4, 2021 at 0:13

1 Answer 1


The answer is they are quite different. The SCOTUS found almost 100 years ago that the Several States have the power to require vaccinations. This is one of the "reserved powers" under the constitution. The Texas Heartbeat law creates a regulation on doctors (similar) and a civil cause of action (very different).

However, the biggest difference is that the older case permits the state to require medical treatment while the Texas law requires a medical justification for treatment.

It seems uncontroversial to require a doctor's services to perform an abortion. However, now the Texas legislation is in effect codifying the medical ethics requirement to "do no harm." Medical ethics do allow exceptions based on a specific situation, and so does the law.

A mandatory vaccination law is almost the opposite. It guides doctors that the general risks of vaccination are not strong enough to be considered harmful when weighed against the benefits of the vaccination. But, of course, medical ethics would also allow exceptions based on specific situations, and so should the law.

Fizz already cited the case: Zucht v. King https://supreme.justia.com/cases/federal/us/260/174.

  • Zucht v. King, I think. Actually "In a brief opinion, the Court noted that in the previous case of Jacobson v. Massachusetts, the Court "had settled that it is within the police power of a state to provide for compulsory vaccination"." Sep 4, 2021 at 0:13

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