The U.S. Supreme Court signaled on Monday that it may favor loosening New York’s strict school vaccine requirements, which do not allow for religious exemptions.
The court vacated a federal appeals court ruling upholding the vaccine requirements and ordered the lower court to reopen the case “for further consideration.”
For years, New York had allowed exemptions to school immunization requirements for students who held religious objections to vaccines or were unable to be vaccinated for medical reasons. But after a large measles outbreak that was concentrated in Orthodox Jewish communities in Brooklyn and Rockland County, New York State eliminated the religious exemptions in 2019.
In the years since, childhood vaccination rates against measles climbed in New York. But the change to the law was challenged by a lawsuit filed in Rochester by a number of Amish people and schools on the grounds that it interfered with their right to practice their faith and impart their religious values to their children. At least two federal courts in New York rejected their arguments.
New York is one of only five states not to offer an exemption from school vaccine requirements for religious or personal reasons, and, in one of those states, West Virginia, the governor has sought to introduce them.
In its March ruling, the Second Circuit U.S. Court of Appeals, in Manhattan, noted that in the years before the 2019 change a growing number of parents were receiving religious exemptions from vaccines for their children, undermining disease control efforts.
At private and parochial schools, the percentage of students invoking religious exemptions had jumped from .54 percent to 1.53 percent, according to the court record. In Rockland County, an epicenter of the 2019 measles outbreak and home to a large ultra-Orthodox Jewish community, up to 20 percent of students had religious exemptions at some schools.
The religious exemptions “resulted in clusters of low vaccination rates and an inability to achieve herd immunity in certain communities,” the ruling said.
Epidemiologists estimate that at least 95 percent of a community needs to be vaccinated to protect a community from a measles outbreak.
Dr. Howard Zucker, a former New York State health commissioner, said that declining vaccination rates nationwide have led to a resurgence of measles. An outbreak in the Southwest this year has led to more measles cases nationally than in any year since 2000, when the virus was declared eliminated in the United States.
“The decision to eliminate the once exploited religion exemption for vaccinations in New York State was grounded in public health principles: protecting herd immunity and preventing outbreaks,” said Dr. Zucker, who had advocated eliminating religious exemptions for school immunization while health commissioner.
The removal of religious exemptions has been credited with increasing childhood vaccination rates against measles in New York. But some schools — including three Amish schools that challenged the change to the law — did not require proof of vaccination before enrolling children, according to health authorities. The state fined the three schools $118,000 in all, triggering the lawsuit.
“The Amish community in New York wants to be left alone to live out their faith just like they have for 200 years,” said Kelly Shackelford, president of First Liberty Institute, a conservative legal organization that defends religious freedom and represents the Amish men and schools in the Rochester suit.
The order from the Supreme Court did not direct the lower appeals court to reach a particular result, but lawyers at First Liberty found the development encouraging.
The Supreme Court order directed the Second Circuit to reconsider the case in light of a recent ruling on religious freedom involving a very different topic. The ruling that the Supreme Court cited, Mahmoud v. Taylor, decided in June, involved storybooks with L.G.B.T.Q. themes and whether parents with religious objections could have their children excused from classes where the books were discussed.
First Liberty has argued that the Supreme Court’s ruling in the storybooks case shows that the Second Circuit was too dismissive of the Amish parents’ claim about how the school vaccine requirements threatened their religious beliefs.
“We believe the Second Circuit should reach a different result, and it seems that the Supreme Court agrees,” said Hiram Sasser, the executive general counsel at First Liberty.
In a legal brief to the Supreme Court, New York State noted that New York first enacted a school vaccination requirement in 1860, against smallpox. For more than a century, New York’s laws did not contain a religious exemption.
The legal brief also mentioned “the long tradition recognizing the States’ wide latitude to enact neutral and generally applicable laws promoting public health, safety, and child welfare even in the face of competing claims of religious liberty.”
Joseph Goldstein covers health care in New York for The Times, following years of criminal justice and police reporting.
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