As vaccine hesitancy rises, so could claims of religious exemptions

As more parents of young children say they're hesitant to vaccinate their children against common childhood diseases, public health officials are bracing for a rise in litigation related to religious exemptions to school vaccination requirements. 

In the wake of the pandemic and as the public health response becomes less aggressive, more individuals are likely to “use religion as a cover” to circumvent vaccine mandates, said Dorit Reiss, a professor of law at the University of California Law San Francisco, because it’s “harder [for officials] to say no religious exemptions.” 

In the U.S., children are required to be vaccinated in every state and the District of Columbia to attend schools or child care facilities. Specific requirements vary across the nation, but most states require children age 4 or older to receive immunization against measles, mumps, and rubella; poliovirus; chicken pox and other diseases. All 50 states allow exemptions from vaccine mandates for medical reasons, but 13 states allow kids to be excused from that requirement if it’s against their religious or personal beliefs, according to the National Conference of State Legislatures.  

Two parents in Connecticut, for instance, tried to challenge the overturning of a 2021 state law that allowed religious exemptions for school vaccinations. In 2022, parents Keira Spillane and Anna Kehle filed a suit against Gov. Ned Lamont and other state officials in 2022. They claimed that requiring their children to receive vaccines produced using human cell lines derived from aborted fetuses was against their religious beliefs and would violate their religious freedoms under the state and federal constitutions and Connecticut’s Religious Freedom Restoration Act. 

Last month, the Connecticut Supreme Court determined the law requiring children to be vaccinated to attend school could still stand, but the justices did send one of the parents’ six claims in the suit back to a lower court. The claim centers around if the 2021 law violated the state’s Religious Freedom Restoration Act. 

“This decision is a victory for our plaintiffs and a victory for religious freedom in Connecticut and we look forward to pressing ahead with our injunction motion so that we can get these disenfranchised children back to school while we await our trial,” said the parents’ attorney Lindy Urso in a statement, WTNH reported. 

Similarly, four California parents filed a complaint against California Attorney General Rob Bonta late last year alleging the state’s vaccine mandate for students infringed upon their religious rights. The case was dismissed earlier this year, as the Southern District of California determined personal belief exemptions would not serve the state’s interest in protecting the health and safety of students. 

Also last year, a U.S. district judge ordered Mississippi to allow religious exemptions for vaccines after several parents filed a lawsuit claiming their religious beliefs led them to keep their children out of school. The ruling overturned a 1979 state court decision that determined vaccinated children had the right to not have to associate with unvaccinated peers, The Associated Press reported.

“The fact that courts are leaning toward just accepting their word on [religious objections] means we’re going to see a lot of people get out of [getting vaccinated],” Reiss said. 

In Maryland, for instance, state data shows a stark increase in the number of kindergartners who were exempted from receiving vaccines due to religious beliefs. In the 2002-2003 school year, 0.2% of students received a religious exemption, compared with 2.7% in the 2019-2020 year, Maryland Matters reported. 

Nationally, the Centers for Disease Control and Prevention reported that the 2022-2023 school year saw the highest vaccine exemption rate in the U.S. to date, increasing to 3% from 2.5% in the pre-pandemic 2019-2020 school year. 

“Concerns about vaccines aren’t new, but they grew over the 1980s and 1990s” Reiss said, referring to a 1998 study that falsely linked MMR vaccines to the presence of autism in children. 

Despite vaccination rates generally recovering over the last two decades, with the percent of completely unvaccinated children in the U.S. hovering around 1% to 2%, according to Reiss, the COVID-19 pandemic brought about a new wave of vaccine mistrust among Americans. 

“The pandemic has been politicized, and anti-vaccine groups have taken advantage of that,” she said. Skepticism about vaccinations can also be attributed to the speedy rollout of the COVID-19 vaccine, and low vaccination rates could be an indicator of some families’ difficulty in accessing routine care or other resources to receive immunization. 

Falling vaccination rates pose a public health risk, Reiss said. Vaccines can help prevent and slow the spread of virus outbreaks, such as the spread of measles impacting states like Oregon. 

And as COVID showed officials, containing an outbreak puts a massive strain on governments’ time and resources. If a state has to siphon its public health officials, money and resources to an outbreak, governments’ other priorities, like improving infrastructure and other social needs, may be put on hold, she said. 

To reduce vaccine hesitancy, state legislators should improve education and awareness surrounding vaccines in their public health communication efforts, Reiss said. That can help quell misinformation about vaccinations and encourage more individuals to vaccinate themselves and their children. 

Policies can also impact Americans’ drive to seek vaccinations. According to the National Academy for State Health Policy, for instance, as of January, 21 states ban student vaccine mandates for COVID-19. That includes Texas, which has prohibited any entity in the state from mandating vaccines since 2021. 

"The COVID-19 vaccine is safe, effective, & our best defense against the virus, but should always remain voluntary & never forced," Gov. Greg Abbott said in a post to X, formerly Twitter. 

It’s also critical that the court system is educated on the impacts of immunizations to make more informed decisions about public health, Reiss said. 

“Making vaccines a political issue is bad for all of us,” she said. Instead of the state government or the courtroom, the decision to receive a vaccination “should be between parents and the doctor.”