What the history of compulsory vaccination can tell us about the ethics of HPV vaccine mandates

The licensure of Gardasil in June of 2006 set off a flurry of legislative activity in states around the country. Bills to require HPV vaccination for girls attending middle school were introduced in at least twenty-four states. Over the next two years, however, almost all of these bills stalled or were abandoned. This presentation situates the deliberations about HPV vaccine mandates within the context of two centuries of legally enforced vaccination. I briefly trace the initial efforts on the part of some legislators and policy makers to enact middle school mandates following the licensure of Gardasil. I then examine attempts since the nineteenth century to increase uptake of vaccines via the law and the popular responses these efforts have produced. Many aspects of compulsory vaccination have been subject to debate: their rationales, their purposes, their ethical and legal bases, and their consequences, both intended and unintended. I conclude by considering how empirical historical studies can inform ethical analysis and current policy development.