A Clash Over Vaccine Mandates and Religious Freedom

Florida's Attorney General Challenges Catholic Schools

In a letter to the Florida Conference of Catholic Bishops, Florida Attorney General James Uthmeier demanded that the state’s Catholic schools allow religious exemptions to policies mandating that students be vaccinated. Uthmeier, himself a Catholic, appealed to Florida state law requiring both public and private schools to offer such religious exemptions and threatened to withhold funding from the state’s tuition voucher program if Catholic schools don’t comply. Uthmeier claimed that he wrote the letter in response to complaints from Catholic parents who had expressed concern that their religious convictions were being violated. (Note: Uthmeier’s letter is apparently only available as an attachment to a post on the social media site X—it is not posted on the attorney general’s official web site.)

In a brief statement in response to the letter, Michelle Taylor, a spokesperson for the FCCB, said, “Be assured, Florida’s Catholic schools are operating in accord with the law and Church teaching.” Taylor also explained that the bishops would provide a more detailed response by this weekend. It’s unclear if all Catholic school systems in Florida disallow religious exemptions, or only some.

Religious exemptions to vaccine mandates have been a major issue of contention since vaccinations against COVID-19 were introduced near the end of 2020, and these mandates have received renewed attention in response to the recent measles outbreak in the United States, the latter driven largely by unvaccinated children catching and spreading the disease. The debate over these exemptions has largely focused on whether, and in which cases, parents have a right to have their children exempted from mandates imposed by state governments requiring vaccinations for school attendance. The current Florida case adds a new layer of complexity since, first of all, it involves a state attempting to impose a mandate to permit religious exemptions, and second because the Catholic bishops are appealing to the religious liberty of Catholic schools to defend their refusal to allow religious exemptions.

Before diving into that complex case, however, it will be helpful to look at the ethical and legal issues involved in religious exemptions to school vaccine mandates.

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The US federal government does not mandate vaccines for students, nor does the First Amendment to the US Constitution or any federal law require religious exemptions to such mandates. Policy regarding vaccine mandates and exemptions is handled at the state level. All fifty US states mandate vaccinations for students attending public and private schools, although they maintain slightly different lists of required vaccines. Every state allows exemptions for medical reasons (such as when a child is allergic to a vaccine or is immunocompromised), and most allow for religious exemptions, as well (only California, Connecticut, Maine, and New York currently allow only medical exemptions). Some states also allow for “personal” or “philosophical” exemptions when parents object to vaccinations in general or to a specific vaccination for reasons that are not explicitly religious. Interestingly, a handful of states require parents filing for a religious exemption to complete an evidence-based educational module on the health benefits of vaccines before the exemption is granted.

In states that allow religious exemptions, the primary qualification is that the religious belief be sincerely held. This means that the parents’ objections to vaccination should not be personal or political beliefs masquerading as religious beliefs. States vary in how they require parents to attest to the sincerity of their religious beliefs, with some requiring a written statement explaining the religious reasons for the proposed exemptions and others simply requiring parents to sign a form attesting to the fact that the vaccination of their child would violate their sincerely held religious beliefs.

The main difficulty here is that this makes state and local officials responsible for evaluating the sincerity of parents’ religious beliefs, a task for which they are ill-suited and which raises First Amendment questions of its own. In general, state laws—as they have been interpreted by the courts—place reasonable restrictions on how the sincerity of religious beliefs can be assessed by the government. For example, parents do not need to belong to an organized religious institution with formal teachings opposing vaccination in order to have sincere religious opposition to vaccines. The parents likewise do not need to scrupulously follow every aspect of their religion’s teachings for their religious claim to be valid (a point I raised many years ago in relation to the Affordable Care Act’s contraceptive mandate). And finally, parents’ religious beliefs can be sincere even if they disagree with the official teachings of their religion. It is not the government’s job to enforce religious orthodoxy under the guise of protecting religious freedom.

Given the challenges of evaluating religious exemption claims, why offer them at all? The state has a strong public interest in requiring vaccinations for children, both for the sake of the health of that child and to prevent the spread of disease (especially to those who cannot be vaccinated for medical reasons). But that public interest has to be weighed against the religious liberty of parents, and most US states have found that balance is maintained by enforcing vaccine mandates while allowing religious exemptions. In some states (including Florida), the religious freedom of parents has been reinforced by state-level Religious Freedom Restoration Acts. Religious exemptions have also historically been popular with the electorate. Increasing skepticism about vaccines and the consequent spread of diseases like the measles, however, have upset this delicate balance.

(Photo: Centers for Disease Control, Unsplash)

Of course, the legal question of whether religious exemptions should be permitted is distinct from the moral question of whether parents should request one. Catholics have engaged in a lively discussion of this latter question especially since 2020, although debates over the appropriateness of using vaccines produced using cell lines derived from tissue from aborted fetuses long predate the COVID pandemic. Soon after the first COVID vaccines were released, Pope Francis issued a video statement encouraging Catholics to get vaccinated, calling it an “act of love.” The Congregation (now Dicastery) for the Doctrine of the Faith, noting that cell lines derived from the tissue of aborted fetuses had been used in the research or production of some, although not all, of the COVID vaccines on the market, nevertheless concluded that it is “morally permissible” to use those vaccines (especially in situations where alternatives are not available), and added that “the morality of vaccination depends not only on the duty to protect one's own health, but also on the duty to pursue the common good.” Even so, it likewise stated that some may still refuse to use these vaccines for reasons of conscience, but these individuals then have an added obligation to engage in other behaviors that will help prevent the spread of disease to vulnerable people. It’s not clear if these moral objections should necessitate an exemption if and when a vaccine mandate is imposed, however. The United States Conference of Catholic Bishops (USCCB) had issued similar guidance a few days earlier. These guidelines were developed in response to the introduction of the COVID vaccine but can be applied to vaccines more generally.

The Catholic Church’s official stance is, therefore, somewhat complex. On the one hand, Catholics are by no means morally obligated to avoid vaccines developed using illicit means if there are no alternatives available. Indeed, Catholics have strong moral reasons to get vaccinated and to have their children vaccinated. Similarly, Catholics cannot appeal to official Catholic teaching to justify a religious exemption. On the other hand, the Church recognizes that some Catholics may personally object to vaccines researched or developed using illicit means, although it’s not clear whether that implies those moral objections justify exemptions from vaccine mandates when those are implemented. Catholic teaching does not, however, acknowledge more general objections to vaccines. It’s also not clear what the Church’s stance would be on respecting the consciences of parents with sincerely held but spurious objections to vaccines, such as an alleged link to autism.

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Florida state law mandates that students attending both public and private schools must obtain certain vaccines, but the same law also allow parents to request a religious exemption for their children by providing a written statement explaining their religious objections. As I already mentioned, Attorney General Uthmeier appeals to this law in his letter to Florida’s bishops.

Because Catholic schools are religious institutions, however, the right to religious freedom may provide grounds for objecting to a law that requires religious institutions to act in ways contrary to their religious beliefs. This argument about religious freedom was used at the federal level, for example, to oppose the Affordable Care Act’s contraceptive mandate, which required Catholic institutions to offer their employees health insurance that provided coverage for contraceptives, the use of which is prohibited by official Catholic teaching (except in cases where the contraceptives are used to treat a medical condition). The FCCB claims its refusal to permit religious exemptions is likewise grounded in religious belief.

Although the FCCB have not yet made public their legal response to the attorney general, I assume they will appeal to Florida’s Religious Freedom Restoration Act, which mimics its federal namesake. This law states that if an individual or religious institution can show that a law with general applicability places on them a “substantial burden” in violation of their religious beliefs, then the government must show that the law is “in furtherance of a compelling governmental interest” and “is the least restrictive means of furthering that compelling governmental interest.” In other words, the government must show that not only are there good reasons for requiring the policy that violates the person or institution’s religious beliefs, but also that there is no other way of achieving the same objective without violating those religious beliefs.

Attorney General Uthmeier argues that the state has a compelling interest in protecting the religious freedom of families who send their children to Catholic schools. In making this case, however, he makes the mistake of questioning the sincerity or validity of the Florida bishops’ religious beliefs. Likewise, he fails to make the case that forcing the bishops to permit religious exemptions is the only way of protecting this compelling interest.

In his letter, Uthmeier appeals to the Catholic Church’s strong defense of the right to religious freedom and its moral objections to the use of cell lines derived from the tissue of aborted fetuses in the development of vaccines. He states:

[A]s a Catholic, I am confident that the teachings of the Church do not require Catholic schools to compel students to take vaccines derived from the tissue of aborted children against the sincerely-held religious objections of their parents.

In later remarks, Uthmeier pointed to the variation in diocesan policies across the US as evidence that the refusal to permit religious exemptions in Florida’s Catholic schools is not based in religious belief.

At first glance, Uthmeier appears to have a point. After all, although the Church teaches that parents have a strong moral duty to protect the health of their children and the community, they are not morally obligated to have their children vaccinated. Similarly, the Vatican seems to suggest that Catholics can in good conscience raise moral objections to certain vaccines. Although Uthmeier doesn’t cite it, the USCCB itself issued guidance in 2007 and updated in 2015 suggesting that “in an area where public schools are granting a conscience exemption, . . . Catholic institutions should be willing to do so as well.”

Legally speaking, however, this is all largely irrelevant. As Notre Dame law professor Rick Garnett stated in an interview with OSV News, “[I]t is not remotely the role of a government official, even a Catholic one, to tell the bishops what to teach or how to run the church's apostolates. . . . It is certainly not up to him to decide whether the Catholic bishops' reasons are 'legitimate.'” In other words, it is outside the authority of the State of Florida to determine whether the religious beliefs put forward by the state’s bishops are authentically Catholic.

Uthmeier’s inappropriate focus on this religious question apparently leads him to ignore the legal burden he will need to meet if the case ever reaches the courts: proving that enforcing the state law on religious exemptions is “the least restrictive means of furthering” the state’s interest in protecting parents’ religious freedom.

Here, Garnett raises what I think is a crucial issue:

If a parent objects to these vaccines, which the church teaches are morally permissible and which clearly serve the common good of the community, they may move their children to state-run schools. . . . No one has a “right,” however, to require a Catholic school to conform with his or her own private judgments.

It is not a violation of religious liberty if parents voluntarily send their children to a religious school that has policies that conflict with the parents’ religious beliefs. Therefore, Florida’s law requiring Catholic schools to permit religious exemptions is overly burdensome because parents’ religious freedom can be sufficiently protected through enrolling their children in public schools or in private schools that permit religious exemptions.

Applied more generally, Garnett’s argument at first glance seems to give religious institutions a wide exemption from any kind of government oversight—for example, should religious schools be exempt from protecting students from discrimination based on race, if that discrimination was based in religious belief, because their parents could enroll them elsewhere?—but the argument seems to hinge on the fact that in this case the parents’ complaint is specifically about religious belief.

My first read, then, is that the Florida bishops have the stronger legal case here, although as I said, we have not yet seen their legal defense. On the other hand, I’m not absolutely sure that the policy of disallowing any religious exemptions at Catholic schools is wise. After all, as I explained earlier, such a policy is not required by Catholic teaching and in fact goes against guidance from the USCCB. But one could counter that the context has changed since that guidance was issued. The number of religious exemptions granted to vaccine mandates has increased significantly over the past several years, and childhood vaccination rates are declining, and as a result, childhood cases of measles and whooping cough are on the rise. Florida Governor Ron DeSantis and Surgeon General Joseph Ladapo have pushed, so far unsuccessfully, to entirely eliminate school vaccine mandates, with Ladapo stating, “Every last one of them is wrong and drips with disdain and slavery.” The Catholic schools’ policy could be seen as a counter-witness in favor of the common good against such radical individualism. Finally, considering that the objections to school policy are coming from Catholic parents, the policy helps avoid the confusion over the Church’s stance on vaccines if religious exemptions were granted based on ostensibly Catholic grounds.

It will be crucial to pay attention to this clash as it unfolds, given its implications for not only religious freedom but also public health.