Category Archives: Exemptions

Religious Exemption: The Law – a Summary

Religious Exemptions – the Law:


The Federal Constitution does not require a Religious Exemption:

  • School immunization requirements are constitutional (Zucht v. King, 260 U.S. 174, 177 (1922): (no exemption in that case).
  • Parental rights & religious freedom do not overcome child’s welfare. Prince v. Massachusetts, 321 U.S. 158 (1944): Case focused on child labor law; had a comment addressing compulsory vaccination.
  • Neutral, generally applicable laws can be applied even to those with religious opposition. Emp’t Div., Dep’t of Human Res. of Oregon v. Smith, 494 U.S. 872, 890 (1990).
  • Most recently, principles applied in: Phillips v. City of New York, (2015, 2nd circuit) (cert denied).

A State Religious Freedom Restoration Act can be overcome by subsequent legislation, and hence does not prevent abolishing the religious exemption either. In addition, at least one case suggested preventing infectious disease is a compelling state interest: Workman v. Mingo Cnty. Bd. of Educ., 419 F. App’x 348, 353–54 (4th Cir. 2011) (per curiam).


Limits on Scope and Application of Religious Exemptions:

  • Most courts ruled: you cannot limit the exemption to organized religion. Dalli v. Bd. of Educ., 267 N.E.2d 219, 222–23 (Mass. 1971); Brown, 378 So. 2d at 223, cert. denied, 449 U.S. 887 (1980). One exception – Kentucky – overturned later by legislature.
  • If the legislature did not require a show of sincerity for a religious exemption, several courts ruled that officials cannot demand a show of sincerity. In re LePage, 18 P.3d 1177, 1180 (Wyo. 2001); Dep’t of Health v. Curry, 722 So. 2d 874, 878–79 (Fla. Dist. Ct. App. 1998).
  • Belonging to a religion that supports vaccines does not mean someone can be denied an exemption: focus on personal belief, not orthodoxy. Berg v. Glen Cove City Sch. Dist., 853 F. Supp. 651 (E.D.N.Y. 1994); Matter of Shmuel G. v. Rivka G., 800 N.Y.S.2d 357 (N.Y. Fam. Ct. 2005).


Is a Religious Exemption a Good Idea?

For Religious Exemption: Against Religious Exemption:
Respect for religious values and religious freedoms. Unfair to put child at risk because of parents’ religious belief – child did not choose religion.
As long as numbers small enough, does not undermine herd immunity, little or no risk. Jurisprudence makes it impossible to limit numbers of those using exemption – very hard to police – so does undermine herd immunity & creates risk.
Jurisprudence that makes it hard to police encourages people to lie & unfairly advantages good liars.
No mainstream religion opposes vaccination. Even Christian Science does not directly prohibit it – especially if legally required. See: Mary Baker Eddy, The First Church of Christ, Scientist, and Miscellany 219–20 (1917); Christian Science Sentinel, view?q=quarrel+vaccination& (last visited Aug. 1, 2014).

Measles, exemptions, legal changes

“In reaction to the outbreak, politicians in many states proposed bills tightening exemptions from school immunization requirements.[10] This short article examines the law and legislative trends in this area.

Several states have exemption rates that are too high to preserve herd immunity. Oregon, at 7.1%, is at a high risk.[42] California has a low rate of exemptions overall, but has areas where rates of immunization are low.[43]Maine, Michigan, and Washington all have high exemption rates.[44] These states all face a real risk of disease. At least tightening these exemptions is a powerful idea.

Religious exemptions are completely inappropriate due to their vulnerability to abuse and the unfairness of putting the child at risk for beliefs the parents hold and the child is too young to choose. On the other hand, however, a system that does not leave parents any way to refuse vaccination is too extreme.

At the very least, since the public health argument is not as strong for homeschoolers, it makes sense to exempt children who are homeschooled from immunization requirements. Offering a hard-to-get personal belief exemption is preferable to a religious exemption, but should be harder to obtain than even the educational requirement currently in place.  Ideally, getting the exemption would require a daylong course with a short quiz at its end. The course requirement would help limit exemptions to only the very small set of parents with the strongest feelings against vaccines, parents who believe that asking them to vaccinate is akin to asking them to poison their child.”

Article: Tools for dealing with Childhood Vaccination Crisis

Responding to the Childhood Vaccination Crisis: Legal Frameworks and Tools in the Context of Parental Vaccine Refusal

Dorit Rubinstein Reiss

University of California Hastings College of the Law

Lois A. Weithorn

University of California Hastings College of the Law

March 4, 2015

Buffalo Law Review, Vol.63, August 2015, Forthcoming
UC Hastings Research Paper No. 134 


In spite of vaccines’ impressive record of safety and effectiveness, some families have failed to immunize their children, denying those children protection against vaccine-preventable diseases. In the last years, rates of nonvaccination, as well as rates of partial adherence to vaccination schedules, have been increasing. Predictably, this has led to outbreaks of vaccine-preventable diseases. This article examines potential legal responses to this crisis. It sets out the legal framework governing childhood vaccination policies, highlighting the strength of governmental authority when the state’s police power to protect the public health and its parens patriae authority to protect the health of children and other vulnerable members of society converge, as they do in this context. After describing the phenomenon of nonvaccination, the reasons leading to parental refusals and the effects of those refusals, the article provides a menu of legal tools that can be used to improve vaccination rates.

Influenza Mandates and Health Care Workers:

First Do No Harm: Protecting Patients Through Immunizing Health Care Workers.

Dorit Rubinstein Reiss

University of California Hastings College of the Law


Rene F. Najera

John Hopkins University, Bloomberg School of Public Health

To protect vulnerable patients, hospitals increasingly adopt policies requiring health care workers to be vaccinated against influenza. More than twenty states have also enacted statutes or regulations on the topic. A small minority of health care workers oppose the requirement, and several have appealed to our courts of justice.
This article examines the legal issues surrounding influenza mandates for health care workers, including the constitutional framework, federal employment discrimination statutes, and the effect of collective bargaining. It argues that requiring vaccination for health care workers is both ethical and appropriate. While better done via state statute, hospitals have the authority to require vaccination from their workers – and are not, arguably, required to exempt any workers that do not have medical barriers to vaccination.

Law and Vaccines: A Manual

This is the manual about law and vaccines prepared in collaboration between myself, Amanda Naprawa and Voices for Vaccines. It covers a range of issues.


Legal Topics: 

Vaccines: Regulating the Product

Protecting the Public Health: State and Federal Law

Disease Prevention: The CDC’s Role

Immunization Schedules

School Immunization Requirements

Religious Exemptions

Vaccines: Individual Choice and Community Welfare

Community vs. Individual: Achieving a Balance of Rights

Religion, Employment, and Rights

Parental Rights and the Child’s Right to Health

Informed Consent

Informed Refusal: The Risks of Not Vaccinating

Increasing Immunization Rates: The Role of the Law 


Government-Funded Incentives and Subsidies

Imposing Costs: Civil Lawsuits.

Imposing Costs: No-Fault Options

Limiting Unvaccinated Individuals’ Access

Vaccine Refusal and Criminal Law

Forced Vaccination

Other Issues: 

Vaccine Injuries: Compensating the Rare Adverse Event.

NVICP vs. the Courts

Are Vaccines “Unavoidably Unsafe?”

Responding to Maine’s Coalition for Vaccine Choice’s Law:

The Maine Coalition for Vaccine Choice proposed a very problematic law that could mislead parents into not vaccinating because of false claims and would go against public policy. This post explains the problems with the law.




Influenza Vaccine Mandates and Health Care Workers: a Response

Responding to Attorney Alan Phillips’ claims claiming that there are many things unconstitutional or illegal in imposing such mandates.


This is the second in a two-part series: in the first part, Skeptical Raptor tackles Attorney Phillips’ science-based claims. Here, I address his legal claims.

School Immunization Requirements revisited: Phillips

The district court in Phillips upheld denying exemption and excluding unvaccinated children from school during an outbreak. We should mobilize.

I did not write about the appeal results in the 2nd Circuit court of appeals because there’s no new ground there. But here is a good analysis by Andy Baker from the Network for Public Health Law:

Religious Exemptions: Abuse and Reform

This post and article document that people lie to get religious exemptions, and address the jurisprudence surrounding exemptions and possibilities for reform.


Blog post:


Full article:

Response to Alan Phillips: Exemptions not Required

This is a response to comments by Attorney Alan Phillips and an explanation why religious – or philosophical – exemptions are not required under our constitutional framework:

Rights of the Unvaccinated Child 5:

The fifth post in a series published with Shot of Prevention examining the tension between a child’s right to health and parental rights, and what can be done to protect children. This post looks at school immunization requirements and how they can protect children from non-vaccination.