A Quick Story About Measles

In Buck v Bell, the Supreme Court agreed with the Commonwealth of Virginia that the state had the authority to forcibly sterilize people due to a developmental delay or intellectual disability. Justice Oliver Wendell Holmes, Jr., writing for the majority (it was an 8-1 decision), wrote:

“It is better for all the world if, instead of waiting to execute degenerate offspring for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Jacobson v. Massachusetts, 197 U.S. 11. Three generations of imbeciles are enough.”

By “three generations of imbeciles,” Justice Holmes was referring to Emma Buck, Carrie Buck and Vivian Dobbs: the grandmother, mother and daughter. At the time Virginia was trying to forcibly sterilize Carrie Buck because, according to some dubious claims, she was 18 but had the mental capacity of a 9 year-old. (Her mother was said to be also developmentally delayed.) Another factor that drove the authorities to do this was Carrie becoming pregnant out of wedlock and having Vivian.

Carrie would be forcibly sterilized in 1927, shortly after the court’s decision.

Although Vivian was said to be “feebleminded” like her mother and grandmother, there is good evidence that she was not. In 1931, Vivian made the honor roll at her public school in Charlottesville, Virginia. Unfortunately, we will never know the true potential of Vivian. She died of complications of measles in 1932. Her mother, Carrie, would live into the 1980s and described as an avid reader and not really showing many of the intellectual disabilities described in the court filings.

Today, many anti-vaccine groups will point to the Buck decision and claim that “the state” has the authority to force children to be vaccinated. However, as Dorit Reiss, PhD, explained in a previous blog post on this blog:

“In at least one of the cases attacking California’s 2015 immunization law, plaintiffs suggested that the reliance on Jacobson in Buck v. Bell taints Jacobson, arguing that the case should not be used.

That is incorrect. Jacobson stands for the premise that the state can limit individual rights to support a public health necessity through reasonable regulation. The reference to it in Buck is a misuse. The law in question in Buck was not necessary for public health the way school mandates that prevent diseases are; any link between sterilization and public health is speculative, weak, and unsupported with data. And forcing such a procedure on individuals is not equivalent to a vaccine mandate, which, after all, offers benefits to the individual vaccinated – protection from disease – as well as to society. Jacobson was well grounded in principles of good regulation of public health. Buck was not. It is appropriate to repudiate Buck and what it stands for while upholding the validity of Jacobson.”

It is kind of unfortunate that the thing that killed Vivian — measles — is making a comeback in 2019, and that a big reason for that return are people and groups who quote the decision that victimized Vivian’s mother (and so many others) back in the 1920s.

(Read here how The New York Times reported the decision back in 1927: https://nyti.ms/2L8GBuw)

(Listen to a podcast from NPR about Emma, Carrie and Vivian: https://www.npr.org/templates/transcript/transcript.php?storyId=604926914)


Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen