Think vaccinations are a pain? Try avoiding them in court

When individual rights collide with the state’s authority to provide for the general welfare, the state almost always wins.

Nobody likes needles. For one thing, they hurt going in. Plus, if even the slightest thing goes wrong, your arm or backside can hurt for days. Still, all shots are not created equal.

Student vaccinations, immunizations, and inoculations are part of life. Mandatory injections are a state’s way of protecting the health and safety of all public school students, employees, and visitors. All 50 states have laws requiring school vaccinations.

Vaccines are preventive medicine that contain a low dose of a disease-bearing germ (called an antigen) to trigger the body’s immune system. In so doing, it strengthens a person’s ability to ward off contagious diseases such as measles, mumps, polio, chicken pox, rubella, meningitis, tuberculosis, and hepatitis.

Massachusetts passed the first law requiring vaccines for schoolchildren in 1855. Some parents view such requirements as a government overreach. Those parents routinely turn to the courts for relief. They also routinely lose. From the early 1900s, antivaccination lawsuits (including those against school districts) have been spectacularly unsuccessful. Parents base their objections on moral, religious, medical, economic, and other grounds. But unless state law has carved out a specific exemption, courts are largely unsympathetic.

In a New York minute

The latest example is a June 2014 federal district court opinion upholding the New York City school district’s immunization policy. The directive bars unimmunized students from attending school if a classmate has a communicable disease that most other children have been vaccinated against. New York state law obligates all students to be vaccinated unless parents claim a religious objection or present a doctor’s note saying immunization would harm the child.

The case involves three families and two legal angles. Dina Check and daughter Mary stand out. Mary received a religious exemption (later revoked) and was banned from school when another student developed chicken pox. Check said barring her daughter violated both the First Amendment free exercise clause and 14th Amendment equal protection and due process rights.

Most court cases conclude that the public health of millions of U.S. kids trumps any individual objection.

Check told the U.S. District Court for the Eastern District that vaccinating her child “would defile God’s creation of the immune system . . . (and) demonstrate a lack of faith in God, which would anger God and therefore be sacrilegious.” Daughter Mary also suffers from gastrointestinal problems, Check contended, and could get sick from the shot.

In deciding for the school district, the Brooklyn federal judge reached back to a 1905 U.S. Supreme Court case to justify his ruling. Jacobson v. Massachusetts involved a man who was fined $5 when he refused to get a smallpox vaccination during an outbreak. (That would be a $135 fine today.) The early 20th-century Supreme Court concluded that government’s duty to safeguard all its citizens should take priority.

The 2014 New York decision was widely hailed as a public health victory, in addition to reinforcing the power of schools to require vaccinations. On Jan. 7, 2015, the U.S. Court of Appeals for the 2nd Circuit upheld the lower court ruling, and thus the school district’s policy to exclude Mary Check from being vulnerable to a disease that a vaccination would likely prevent.

The stage has been set lately for conflict. Public health officials, according to the New York Times, are increasingly concerned “that some diseases are experiencing a resurgence in areas with low vaccination rates.” At the same time, many states have passed statutes allowing for sincere religious objections, causing people with other protests to wonder why they don’t qualify for the same treatment.

Legitimate disagreement

Parents who become would-be shot blockers have their reasons. Some say their religious faith forbids them from putting a foreign substance of any kind — including medicine — in the bodies of their children. Others strain with the cost of a doctor visit or paying for the vaccination. Still others cite fear that vaccines will provoke sickness instead of health.

Some parents have a philosophical objection to government interference in their lives. While some states permit philosophical objections, at least one court has ruled that it’s not enough. A 1988 case from Watertown, N.Y., confronted that issue head-on. The 2nd U.S. Circuit Court of Appeals favored the district in Mason v. General Brown School District.

Parent C. Edgar Mason said he and his son were committed to living in a “natural order … over and above a level of scientific belief.” They argued that they base their lifestyle on a “genetic blueprint,” which they said was equivalent to a religious belief. The federal court saw things differently, saying that Mason’s beliefs were “simply an embodiment of secular chiropractic ethics.”

A supreme conflict

It is an age-old tension between the power of government to regulate for the general welfare and the individual’s right to do as he or she pleases, especially on religious grounds. The U.S. Supreme Court declared in the late 1800s that freedom of belief is absolute, but freedom of action is not. In Prince v. Massachusetts, a 1944 case primarily over child labor laws and religious freedom, the court outlined the parameters of parental versus state authority: “[The state’s] authority is not nullified merely because the parent grounds his claim to control the child’s course of conduct on religion or conscience . . . . The right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death.”

The legal battle over mandatory vaccines even made a recent appearance at the U.S. Supreme Court. West Virginia parent Jennifer Workman refused to get her 6-year-old daughter vaccinated, saying her older daughter experienced developmental delays due to the immunizations. She said she also had religious objections. When the federal appellate court sided with the school district, Workman asked the Supreme Court in 2011 to intervene. Justices declined to review the lower court opinion, letting stand the lower court ruling against Workman.

Fundamental rights

Not all cases merit federal review. In November 2013, the West Virginia Court of Appeals ruled in D.J. v. Mercer County Board of Education on a challenge to new, statewide school vaccination requirements. Under state law, the court found that the fundamental right to an education was a public one, not a private right. Hence, since protecting public health and safety is one of the most important roles of the state, the vaccination requirement was sufficiently compelling to be upheld.

Even federal government officials weigh in on the side of vaccination. A portion of the Centers for Disease Control and Prevention web site  (www2a.cdc.gov/nip/schoolsurv/schImmRqmt.asp) includes a state-by-state map of school vaccination laws and related background information.

In May 2014, the Congressional Research Service published “Mandatory Vaccinations: Precedent and Current Law,” which explains that “Vaccination has resulted in the eradication of smallpox worldwide and in the control of many other vaccine-preventable diseases. Mandatory vaccination programs such as school immunizations have played a major role in controlling rates of vaccine-preventable diseases in the United States.”

While vaccination opposition can receive a chilly reception in court, one exception is embedded in federal law. The McKinney-Vento Homeless Assistance act aggressively protects the education of homeless students. That law demands that school districts enroll homeless students immediately, even if they lack immunization records.

Most court cases conclude that the public health of millions of U.S. kids trumps any individual objection. Children are among our most vulnerable citizens. They do not have fully developed immune systems nor decision making powers independent of their parents under the law. School officials are duty bound to put the health, welfare, and safety of students first. While objectors have a legitimate point, ultimately the greater good wins legal priority.

Citation: Darden, E. (2015). Ed law: Think vaccinations are a pain? Try avoiding them in court. Phi Delta Kappan, 96 (6), 74-75.