Was Jacobson v. Massachusetts the original MAHA?

What is MAHA? “Make America Healthy Again” is a mandate from a movement. The political target is chronic illness; who can say no to that? While the media keeps us focused on the ebb and flow of the pandemic of the week, Americans are suffering – quietly and chronically. MAHA allows us – finally – to ask why, out loud.

MAHA is a response to the heavy hand of the government during the declared COVID pandemic. Chronic illness didn’t spring up suddenly; it’s been creeping into American life for decades, sucking away our vitality. Our new Health and Human Services Secretary, Robert F. Kennedy Jr., often refers back to his childhood in the 1950s and 60s, where he did not see obesity and heart disease and allergies and autism and sudden deaths among his friends and family. All of those were rare – especially among children. What happened?

This is the real mandate of MAHA: asking what happened and putting it on record. “By the mid-20th century, chronic illnesses, such as cancer and heart disease, had supplanted infectious disease as the leading causes of morbidity and mortality.”¹ Many paths with broken street lamps need illumination on the way to determine what sickened America. And there are countless moms and dads and civic-minded citizens and God-fearing folk who have stood up over the last century to protest things like pesticides, unnatural lighting or radio signals, GMOs, seed oils, pasteurization, unsanitary living conditions, and various medical interventions and inventions.

One of those pioneers was father and pastor Henning Jacobson. You can read about his famous refusal of the smallpox vaccination in the early 1900s that resulted in a landmark Supreme Court case, Jacobson v. Massachusetts, in SHF’s article, “The power of one voice.” As described by Leslie Manookian of Health Freedom Defense Fund (HFDF), in that case, “the court said that in a very very narrow situation – in an extreme emergency – with a death rate of 30-40%, like in smallpox, not COVID, which is like… the seasonal flu or slightly higher, that an area – a city, a small entity – did have the authority to mandate a vaccination or to fine those who refuse to take it.”²

Manookian is an expert on the Jacobson case, citing it in multiple groundbreaking cases brought by HFDF challenging unconstitutional and irrational COVID policies. Stand for Health Freedom Executive Director Leah Wilson interviewed her in June 2024 about an historic victory in the notoriously difficult 9th Circuit, where she successfully stopped COVID shot mandates in the Los Angeles School District. “This case, what it says is that any medical intervention that is only intended for the benefit of the recipient cannot be mandated. That’s what it says. And that’s now controlling law in the biggest circuit in this country – in the 9th Circuit.” The 27-minute interview is well worth the investment of time. Manookian gets right to the point, linking the significance of the legacy of the Jacobson case to what is happening today in pandemic policy.

HFDF argued that the ruling in the Jacobson case didn’t apply to the LASD mandate because the COVID shots did not stop transmission, whereas the Jacobson case centered around a state mandate of a vaccine which was believed (and accepted as true by the court) to stop transmission.

Speaking of state mandates, it’s also important to note that health freedom should be fought at the state level, not the federal level. Henning Jacobson was doing just that. He fought a local vaccine mandate by refusing to accept a medical intervention or a fine. In 1902, the city of Cambridge, Massachusetts imposed a smallpox inoculation mandate in response to a local outbreak. The federal government was not involved. It was a local decision. Even the state wasn’t directly involved until Jacobson’s refusal of the vaccine or fine became a criminal case. In the early 1900s, there was no FDA. Cambridge relied on a state law that “empowered localities to enforce general compulsory vaccination when deemed necessary for the public safety.”³ Vaccines were not regulated until 1902 with the Biologics Control Act. “Jacobson was decided in 1905, when infectious diseases were the leading cause of death and public health programs were organized primarily at the state and community levels.”⁴

MAHA has made it to the White House, but it started in local communities. It has its roots in our homes and around our kitchen tables where we discuss our health and the risks and benefits and consequences of following medical advice. It began at our local pediatrician’s offices and county council meetings where we make choices and assert our rights. it took shape as people were told to put on masks, keep kids out of school, stand 6 feet apart, and other ridiculous and dangerous things. But it started long before that, when the government knocked on doors with preselected illness prevention gambles, insisting there was only one way to stop sickness. MAHA began as a groundswell and has grown into a tidal wave.

Public health policy has adapted over the last 120 years. “[T]he trend in public health practice during the 20th century was in the opposite direction from the coercive path toward which Jacobson had pointed. Coercion became figurative and metaphorical and was expressed through advertisements that characterized the failure to follow expert hygienic advice as morally culpable or criminal behavior.”⁵ What hasn’t changed is the fact that “public health” isn’t medical advice – it’s policy.

Stand for Health Freedom has created a health policy blueprint to highlight the issues of health freedom that we can take action on right now in our states. You can use it to educate yourself, but also pass it along to your lawmaker so he or she knows the issues that are most important for health freedom. The blueprint points to the Jacobson case as “a testament to the duty of the government to protect our informed consent, our free speech, our parental rights, and our privacy.”

Our article about this case, “The power of one voice,” was published near the beginning of the declared pandemic to encourage people to use their voice and know they were not alone… and here we are in 2025 at the culmination of that hope – so many people who fought alone for so long have now been united under the banner of MAHA. Health policy has taken center stage in the oval office and can no longer be ignored or marginalized by the media.