A Shot of Faith: Vaccine Mandates at the Intersection of Parental Autonomy and the Free Exercise Clause

In recent years, the boundary between individual religious freedom and public welfare has become increasingly contested, as is the case with challenges to mandatory vaccination laws under the Free Exercise Clause. The Supreme Court has long recognized the states’ authority to protect public health, and vaccination can further that interest by protecting individuals from disease and reducing risks to the broader community [1]. Free Exercise doctrine of First Amendment states “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof,” [2] placing important limits on governmental interference with religious exercise. In Jacobson v. Massachusetts (1905), the Court upheld compulsory vaccination as a valid exercise of state police power [3], while Prince v. Massachusetts (1944) recognized that parental and religious liberty is not unlimited when religious conduct threatens a child or the community with communicable disease [4]. Under Employment Division v. Smith (1990), neutral and generally applicable laws may ordinarily burden religious exercise without violating the First Amendment [5]. Yet Fulton v. Philadelphia (2021) [6] and Tandon v. Newsom (2021) [7] further clarified that a law may lose its general applicability when the government permits individualized exemptions or treats comparable secular conduct more favorably than religious conduct.

On September 8th, 2026, the Supreme Court declined a Catholic mom’s request seeking a religious vaccine exemption required for her son (abbreviated as C.F. later in this article) to attend kindergarten later that month. She objected on religious grounds, asserting that her Catholic beliefs required her to keep substances she considered contrary to God’s design out of her son’s body. Justices Alito and Gorsuch claimed that they would have granted the application, but the Court issued no opinion explaining the denial [8]. The dispute raises the question of how courts should evaluate a requested religious exemption. In this article, I argue that courts should examine the particular nature of the disease that the vaccine targets, the risk the exemption poses to third parties, and the operation of comparable secular exemptions. If the government burdens certain constitutional rights, the law may no longer be generally applicable. Then strict scrutiny, the highest standard of review that a court will use to evaluate the constitutionality of governmental conduct, should apply. It assumes unconstitutionality, so the government should present enough evidence to show that their action was “narrowly tailored” to a “compelling interest”. Additionally, the conduct must be the “least restrictive means” to further that interest [9]. In this case, the court should require the New York legislature to demonstrate that denying religious accommodation serves compelling public-health interests, which less restrictive alternatives would not adequately protect. Instead, it simply cited Miller II as the binding precedent case to conclude that the vaccination law was neutral and generally applicable [10].

The New York vaccine dispute illustrates the difficulty of applying generalized public-health evidence to an individualized Free Exercise claim. In Zucht v. King (1922), the Supreme Court upheld the exclusion of unvaccinated children from school, reaffirming that this action falls within the state’s police power to protect public health, as seen in Jacobson. However, it did not address how courts should evaluate a religious exemption when the claimed public-health risk depends on a particular child’s circumstance [11]. The same question remained unresolved in C.F.’s case: whether C.F. posed enough risk to justify denying his accommodation was not independently evaluated. The legal question, however, should not end with the general proposition that vaccination benefits public health. Although New York presented relevant evidence concerning vaccination rates, herd immunity, and past outbreaks, the courts should also have examined the risks associated with C.F.’s particular circumstances. Under Tandon, comparability depends on the risks that religious and secular conduct pose to the government’s asserted interest. If that accommodation posed risks comparable to secular exceptions New York already permitted, Fulton and Tandon suggest that the state would need to satisfy the heightened requirements applicable when a law is not generally applicable.

C.F. had already received twenty-eight doses of nine vaccines and lacked only specific remaining doses, so the nature of those vaccines (i.e., the vaccines’ effect on transmission and the risk his vaccination status posed to others) is relevant to determining whether his requested religious accommodation would actually undermine the state’s asserted interest. The availability of existing secular exceptions is relevant for the same reason. As legal scholar and assistant professor Zalman Rothschild argues, Fulton transformed individualized exemptions into a central part of modern Free Exercise analysis, particularly where governments retain secular exceptions while denying religious accommodations [12]. New York permits some medically exempt students and unvaccinated adults in schools while maintaining outbreak-exclusion procedures. If strict scrutiny is triggered, existing practices are also relevant to whether complete exclusion is the least restrictive means of protecting that interest. New York can reasonably respond that vaccination requirements are preventive so waiting for an outbreak may be too late. Nevertheless, preventive concerns should not eliminate individualized analysis. Finally, the school district urged the Supreme Court to question the mother's sincerity partly because C.F. had previously received many vaccines with some earlier vaccines involving fetal-cell-line development. Neither do Official Catholic sources ban vaccination [13]. Her response was that she came to understand the vaccine issue later, and no lower court had found her beliefs insincere. Supreme Court precedent limited how far courts may go in evaluating such evidence. In Thomas v. Review Board (1981), the Court explained that religious beliefs do not have to be logical, consistent, or shared by every member of the faith to receive First Amendment protection [14]. And United States v. Ballard (1944) held that courts cannot adjudicate the truth or falsity of religious doctrine [15]. This individualized risk inquiry determines the relevant state interest: protecting the child when the risk is primarily personal, or protecting the public when third parties are endangered.

When vaccine refusal primarily affects the child rather than third parties, parental authority and religious liberty becomes more significant parts of the constitutional analysis. The First Amendment protects the free exercise of religion, but that protection does not automatically override every law that might burden religious practice. When the consequences of a religiously motivated decision fall primarily on the individual rather than on third parties, the government has a comparatively weaker third-party public-health justification for overriding that decision. Although Prince recognizes that the state may limit parental and religious liberty when necessary to protect a child or the community from serious harm, the Court also emphasized that the “custody, care and nurture” of children primarily resides with the parents. This suggests that parental authority remains an important constitutional interest even when the state asserts an independent interest in protecting the child. In Troxel v. Granville (2000), the Court recognized a fundamental liberty interest under the Fourteenth Amendment in parents’ decisions concerning the “care, custody, and control” of their children. It further protects parental decision-making by holding that a court may not displace a fit parent’s judgment merely because it believes a different arrangement would “better” serve the child’s interests [16]. Parham v. J.R. (1979) applies that broader principle more specifically to medical decision-making, recognizing that parents retain a “substantial, if not the dominant, role” in decisions, including medical ones, concerning their children. On the other hand, Parham did not give parents absolute authority: the Court required independent medical review before institutionally recognizing that states can intervene when a child’s mental health is seriously jeopardized [17]. Where vaccine refusal creates risk for third parties, cases such as Prince and Jacobson strengthen the government's justification for intervention. Vaccine disputes also implicate the child’s interests independently of both the parent and the state. Leigh Johnson argues that although parents often possess superior knowledge of their children’s needs, parental authority should not necessarily be dispositive when a sufficiently mature minor develops an independent view about vaccination [18]. This is what makes vaccines legally distinctive: they can involve both an individual medical decision and a population-level public-health effect.

When vaccination reduces the risk of transmitting disease to others, the government’s justification for intervention becomes stronger because vaccine refusal can impose risks on third parties who did not make the religious decision. Hillel Levin argues that religious accommodations may raise constitutional concerns when they impose substantial costs or health risks on nonbeneficiaries, who are people who do not benefit from the religious exemption but may bear its consequences [19]. Cutter v. Wilkinson (2005) requires courts to account for burdens that religious accommodations place on third parties [20]. Prince applies this principle in the public-health context, recognizing that religious liberty does not include an unlimited right to expose a child or the community to communicable disease. New York’s elimination of its religious vaccine exemption during the 2019 measles outbreak illustrates this concern: the state acted in response to risks extending beyond individual medical choice to the broader community. Donna Gitter similarly argues that the existence of secular exemptions, such as medical exemptions, does not automatically require corresponding religious exemptions because the two may differ in their impact on the state’s public-health interest [21]. Her argument shifts the inquiry from whether an exemption exists to whether the permitted secular exemption creates risks comparable to the prohibited religious accommodation. Although such a rule may disproportionately burden families whose religious beliefs prohibit vaccination, disparate effect alone does not establish unconstitutional discrimination. Under Washington v. Davis, a Fourteenth Amendment Equal Protection claim generally requires discriminatory purpose, though disproportionate impact may serve as evidence of such intent [22]. The relevant constitutional question is therefore not simply whether religious families bear a heavier burden, but whether the state is impermissibly targeting religion or instead restricting religious exemptions because of substantiated third-party risks.

A significant counterargument is that even when vaccine refusal poses no substantial risk to others, the state may still intervene to protect the child’s own health and welfare. Prince supports this position by recognizing that parental authority and religious liberty are not absolute when a child’s health or welfare is seriously endangered. This changes the analysis because the state may justify intervention through its parens patriae authority–its traditional power to act as a guardian for children who cannot fully protect their own welfare–even without showing harm to the broader public [23]. Yet Prince does not establish that any medical risk automatically displaces parental judgment, particularly when the parents are fit and acting within their traditional caregiving role. Parham recognizes that parents ordinarily retain a “substantial, if not the dominant, role” in decisions concerning their children, including medical care. It limits the reach of parens patriae by preserving a substantial role for parental judgment even when the state has an interest in protecting the child. The counterargument thus narrows rather than defeats this article’s distinction. When only the child is endangered, the state relies primarily on its interest in protecting the child, while parental authority remains constitutionally significant; when vaccine refusal also creates a meaningful risk of transmission to others, the government gains an additional public-health justification. The central question is therefore what level of demonstrated harm is sufficient to justify overriding parental and religious decision-making in the particular case.

The correct standard follows from the Court’s existing Free Exercise doctrine. Neutral and generally applicable vaccine laws ordinarily do not trigger strict scrutiny, which should apply when the government permits individualized or comparable secular exemptions while denying religious accommodations. Courts should therefore compare the actual risks posed by religious and secular exemptions, rather than relying only on their labels. If strict scrutiny applies, the government must show a compelling interest and explain why less restrictive alternatives would not adequately protect that interest. Whether strict scrutiny applies is therefore a threshold question distinct from how strong the government’s interest ultimately is. The strength of the government’s justification should also depend on the nature of the risk. Prince, Jacobson, and Zucht support greater state authority where vaccine refusal threatens children or third parties, while Parham preserves an important role for parental medical judgment. Read together, these precedents make the nature and degree of risk legally significant: risk confined primarily to the child implicates the state’s parens patriae authority, while substantial transmission risk to third parties supplies an additional public-health justification. Thus, the governing question is whether the evidence in the particular case satisfies the doctrinal requirements for burdening religious exercise, not whether courts should generally prefer either religious liberty or public health. Applying this to C.F.’s case, this inquiry was raised but never squarely resolved. His mother argued that no court had found that C.F.’s individual vaccination status—or “one kindergarten seat”—posed a meaningful threat to herd immunity, while New York relied principally on the broader risks associated with vaccine exemptions and disease transmission. The district court did not independently determine how serious the risk to C.F. had to be before the state could override parental and religious decision-making; instead, it treated Miller II as controlling on the likelihood of success and denied preliminary relief. Thus, this case presented, but did not resolve, the question of how individualized risk should affect the government’s justification for denying a religious accommodation.

[1] World Health Organization. “How Do Vaccines Work?” (2/25/2025).

[2] U.S. Const. amend. I.

[3] Jacobson v. Massachusetts, 197 U.S. 11 (1905).

[4] Prince v. Massachusetts, 321 U.S. 158 (1944).

[5] Employment Division v. Smith, 494 U.S. 872 (1990).

[6] 19-123 Fulton v. Philadelphia (2021).

[7] Tandon v. Newsom (2021).

[8] The Washington Post, “Supreme Court Rejects Mom’s Bid for Son’s School Vaccine Exemption in New York” (Sept. 8, 2026), https://www.washingtonpost.com/politics/2026/09/08/supreme-court-rejects-mom-bid-son-school-vaccine-exemption-new-york/.

[9] Wex Definitions Team, “Strict Scrutiny,” Legal Information Institute, Cornell Law School, last reviewed September 2024, https://www.law.cornell.edu/wex/strict_scrutiny.

[10] Miller v. McDonald, No. 24-681 (2d Cir. June 30, 2026).

[11] Zucht v. King, 260 U.S. 174 (1922).

[12] Zalman Rothschild, Individualized Exemptions, Vaccine Mandates, and the New Free Exercise Clause, 131 Yale L.J.F. (2022), https://yalelawjournal.org/essay/individualized-exemptions-vaccine-mandates-and-the-new-free-exercise-clause.

[13] The National Catholic Bioethics Center, “Vaccine Exemption Template Letter,” July 7, 2021, https://www.ncbcenter.org/ncbc-news/vaccineletter.

[14] Thomas v. Review Bd., Ind. Empl. Sec. Div., 450 U.S. 707 (1981)

[15] United States v. Ballard, 322 U.S. 78 (1944)

[16] Troxel v. Granville, 530 U.S. 57 (2000)

[17] Parham v. J.R., 442 U.S. 584 (1979)

[18] Leigh Johnson, My Body, Your Choice: The Conflict Between Children’s Bodily Autonomy and Parental Rights in the Age of Vaccine Resistance, 89 U. Chi. L. Rev. 1613, 1632–40 (2022), https://lawreview.uchicago.edu/print-archive/my-body-your-choice-conflict-between-childrens-bodily-autonomy-and-parental-rights.

[19] Hillel Y. Levin, Why Some Religious Accommodations for Mandatory Vaccinations Violate the Establishment Clause, 68 Hastings L.J. 1223–41 (2017), https://repository.uclawsf.edu/hastings_law_journal/vol68/iss6/1/.

[20] Cutter v. Wilkinson, 544 U.S. 709 (2005)

[21] Donna M. Gitter, First Amendment Challenges to State Vaccine Mandates: Why the U.S. Supreme Court Should Hold that the Free Exercise Clause Does Not Require Religious Exemptions, 71 Am. U. L. Rev. 2243, 2315–16 (2022), https://digitalcommons.wcl.american.edu/aulr/vol71/iss6/3/.

[22] Washington v. Davis, 426 U.S. 229 (1976)

[23] David L. Myers, “Parens Patriae,” EBSCO Research Starters, 2014, https://www.ebsco.com/research-starters/law/parens-patriae.