Whether or not states should order H1N1 flu vaccinations depends on what is meant by "order." Ordering vaccines could mean ordering them for purchase. Presumably, if a state buys vaccines, the intent is to make them available to the public. If that is what is meant by order, states definitely should.
Ordering vaccines could also mean requiring people to receive them. That, states should not do. Though a different age group is the most vulnerable, H1N1 has caused similar numbers of hospitalizations and deaths to a typical seasonal flu. Unlike polio or smallpox, it is certainly not serious enough for people going unvaccinated to have more serious consequences than the interference with civil liberties that mandating vaccines would entail.
As it is, many Americans have trouble getting basic healthcare when needed. Rising costs, lack of adequate health insurance, and decreasing income make it a burden for many. The same problem would apply to mandatory vaccinations, unless government paid the full costs. At a time when states have been cutting some of the most vital services to make ends meet, it would not make financial sense to spend so much money on mass vaccinations against a disease that has not proven any more deadly than the usual seasonal flu. If we were threatened with a much more serious pandemic, it would make sense, but that is not what is happening.
Civil liberties are also at stake. Some people object to being vaccinated for religious reasons. Others believe, correctly or not, that vaccinations are harmful to their health. And it is true that adverse reactions to vaccinations exist. In the interests of civil liberties, individuals who object may be exempt from required vaccinations in certain situations. Parents who oppose vaccinations, for instance, may enroll their children in school without being vaccinated if their beliefs are properly documented.
In the 1970's, an earlier version of swine flu caused significantly fewer deaths than its vaccine. We do not yet know if the situation is the same or different with H1N1. The disease has not been circulating long enough, nor has the current vaccine been in use long enough, for those kinds of statistics to emerge. Until we know more about what risks there may be with the vaccine, and how they compare to the risks of H1N1, it is unwise to mandate the vaccine.
Finally, ordering everyone to receive a vaccination would be a logistical nightmare. How could people prove that they had already been vaccinated? We do not have any coherent system in place for that. With no system for proving it, people already vaccinated might be ordered to receive another vaccine, which would not be healthy. And people not wanting to be vaccinated might claim they already had been, which would defeat the purpose.
How would we come up with enough vaccine for everyone? In many places, there is a shortage as it is. A friend of mine who is in several prime categories for the vaccine - she is twenty-four years old, has a history of asthma, and is a healthcare professional - has been unable to get it because of a severe shortage in New York, where she lives. If states do not have enough vaccine for everyone who wants it, they certainly do not have enough to require it.
And what if a state ordered everyone to receive the vaccine, but neighboring states did not? Would people crossing the state line be required to prove, somehow, that they had been vaccinated? It is very common for people living near a state line to cross the line regularly for errands, or even to work. Some cities and towns straddle state borders. For people in rural areas near state lines, the nearest major city, and the nearest of many types of services, may be in the next state. In such areas, a mandatory vaccination program would be difficult to implement unless it were required in all the states.
This logistical nightmare would be worth dealing with in the case of a very serious pandemic. If H1N1 appeared to cause a death toll on the scale of the 1918 Spanish influenza, or of the polio epidemics of the early twentieth century, ordering mass vaccinations would be prudent. In that case, the interests of public health would take priority over logistical problems and even, to some degree, civil liberties. But as it is, H1N1 is nowhere near that serious.
It has caused hospitalizations. It has caused deaths. But the numbers are no different from ordinary seasonal flu. In contrast to seasonal flu, which mostly affects the very old and the very young, H1N1 disproportionately affects people in the prime of life. However, it is no more serious a pandemic than seasonal flu, and no government has seen fit to mandate seasonal flu vaccines.
For people who want to receive H1N1 vaccinations, it is only right that state governments do everything in their power to make those vaccinations available. But requiring people to receive them against their will is a different story. That should only be done under the gravest of circumstances, which H1N1 does not present.