Vaccines and Verdicts: How Smallpox Court Decisions Affect Anti-Vaccine Discourse and Mortality.

This article examines the impact of compulsory vaccination court decisions on anti-vaccine discourse and smallpox mortality in the United States during the late 19th and early 20th centuries. Using machine learning to analyze nearly 48,000 newspaper pages from the Chronicling America archive, the study finds that pro-vaccine state Supreme Court rulings, including the landmark 1905 US Supreme Court case Jacobson v. Massachusetts, led to a short-term increase in anti-vaccine discourse lasting about two years before returning to baseline. Despite this judicial backlash, compulsory vaccination mandates were associated with significant reductions in smallpox mortality, estimated at around 40%. The research contributes causal evidence on how judicial enforcement of vaccine mandates influences public discourse and health outcomes, highlighting the complex interplay between legal authority, media sentiment, and public health during a critical period in vaccine history.