The United States owes its existence as a nation partly to an immunization mandate.

In 1777, smallpox was a big enough problem for the bedraggled American army that George Washington thought it could jeopardize the Revolution. An outbreak had already led to one American defeat, at the Battle of Quebec. To prevent more, Washington ordered immunizations — done quietly, so the British would not hear how many Americans were sick — for all troops who had not yet had the virus.

It worked. The number of smallpox cases plummeted, and Washington’s army survived a war of attrition against the world’s most powerful country. The immunization mandate, as Ron Chernow wrote in his 2010 Pulitzer Prize-winning biography of Washington, “was as important as any military measure Washington adopted during the war.”

In the decades that followed, immunization treatments became safer (the Revolutionary War method killed 2 percent or 3 percent of recipients), and mandates became more common, in the military and beyond. They also tended to generate hostility from a small minority of Americans.

A Cambridge, Mass., pastor took his opposition to a smallpox vaccine all the way to the Supreme Court in 1905, before losing. Fifty years later, while most Americans were celebrating the start of a mass vaccination campaign against polio, there were still some dissenters. A United Press wire-service article that ran in newspapers across the country on April 13, 1955, reported:

Hundreds of doctors and registered nurses stood ready to begin the stupendous task of inoculating the millions of children throughout the country.

Some hitches developed, however. In Maryland’s Montgomery County, 4,000 parents flatly refused to let their youngsters receive the vaccine. Two counties in Indiana objected that the plan smacked of socialized medicine.

We are now living through this cycle again. The deadline for many workplace mandates arrived this week, often requiring people to have received a Covid-19 vaccine or face being fired. In California, the deadline for health care workers is today.

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