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With the proliferation of COVID-19 vaccination mandates across the country in the public and private sectors as well as in some school districts, the decline in those unwilling or hesitant to get vaccinated is intensifying.
The vaccination effort has raised new questions about exemptions as warrants for adults are generally scarce outside of facilities like healthcare facilities and the military, and vaccinations are relatively new.
While there is no aggregate data on exemptions for COVID-19 vaccines yet, a number of companies and state governments have expressed interest in religious exemptions – protection deriving from the law on Civil Rights 1964.
This leaves employers in the difficult and legally precarious position of determining whether claims are valid. As such, some states have attempted to eliminate non-medical exemptions for their employees altogether.
In schools, where vaccines have long been recognized as essential for preventing communicable diseases, state-level warrants are common and have been tested in the courts.
“One of the most important public health practices we have to mitigate epidemics and things like measles and pertussis are the vaccines required for school or for entry into daycare,” Dr Joshua Williams, Assistant Professor of Pediatrics in the University of Colorado School of Medicine. , told ABC News.
In addition to California’s announcement of the adoption of a statewide mandate, individual education councils in cities like Los Angeles have started adding the Pfizer vaccine, which has received the full FDA approval in September and is currently the only vaccine approved for children over 12 years of age. , to their list of vaccination requirements.
Experts say other school districts are likely to follow suit and have a strong legal basis to enforce the requirement spelled out in the 1944 Supreme Court case, Prince v. Massachusetts.
Here’s what to know about the debate over non-medical exemptions:
On the rise in schools
Data from the Centers for Disease Control and Prevention (CDC) shows that while requests for medical exemptions in schools remain low and fairly constant (around 0.3%), non-medical exemptions (including exemptions from religious beliefs and personal) increased from 1.4% in the 2011-’12 school year to 2.2% for the 2019-’20 school year (an increase of 57%).
In Idaho, for example, in the 2019-20 school year, 7.2% of preschools had non-medical exemptions, according to CDC data. This contrasts with around 1% for states like Massachusetts, Louisiana and Alabama.
Ellen Wright Clayton, professor of pediatrics, law and health policy at Vanderbilt University Law School, believes schools should take a stand against religious exemptions in the interest of protecting public health.
“The point is that parents do not have the right, for whatever reason, to expose the children of other people or other people to [COVID-19] for religious reasons, ”Clayton said.
Schools in all 50 states have historically required immunizations starting at the kindergarten level to curb the spread of contagious diseases such as measles.
Forty-four states and the District of Columbia currently offer religious exemptions to vaccines, 15 of which offer broader personal belief exemptions for personal, moral, or spiritual ideologies. The remaining six states – California, Connecticut, Maine, Mississippi, New York, and West Virginia – only offer medical exemptions.
No more religious exemptions despite the decline in religiosity
Williams, of the University of Colorado, noted that despite a decrease in religiosity among Americans, there has been an increase in requests for religious exemption from vaccination, implying that these exemptions “no longer serve their purpose. initial ”.
It has increased even as some religious leaders including Pope Francis and Rabbi Chaim Kanievsky, a leading authority in Israel’s ultra-Orthodox Jewish community, have made it clear that vaccines are necessary for the common good and have take precedence over religious beliefs.
In his research, Williams also studied the influence of the availability of personal belief exemptions in states on the rate of religious exemptions for childhood vaccinations. In 2016, Vermont eliminated its personal belief exemption policy, which was followed by an increase in religious exemption requests from 0.5% to 3.7%.
This suggests that “maybe people were using this category of religious exemption more and more, even though they didn’t necessarily have a religious objection to vaccines,” Williams said.
“One thing that people have done before has shown that the harder it is to get an exemption, the more the rate of exemptions goes down,” he added.
Unlike personal belief exemptions, which are relatively broad, religious exemptions must be built into a holistic belief system, said Dorit Reiss, professor of law at UC Hastings College of the Law.
“You can’t just type in a Bible verse when it’s convenient for you,” said Reiss, who has written about the legality of immunization warrants in legal journals.
How exemptions work
The rights of individuals to claim a religious exemption from vaccination are protected by Title VII of the Civil Rights Act 1964. However, as seen in some states, this right may be waived in the interests of health. public.
Following the 2019 measles outbreak in New York and Washington states, where most cases were reported among the unvaccinated, states have removed religious exemptions.
When faced with a request for a religious exemption, employers or schools have the right to probe the exemption and question the requester. In other words, it is up to them to assess the sincerity of the belief, not the correctness or validity.
Employers can require their employees to explain in detail the basis for their belief and do not need to accept summary certification to grant the exemption, Reiss said.
“You can’t try to assess whether the belief is rational,” Reiss said. “You can ask them a difficult question to assess sincerity. “
However, employers cannot discriminate in favor of organized religions and therefore are not allowed to request letters from clergy or priests as proof. The rights of employees to challenge accommodations provided by their employer are also protected by the Equal Employment Opportunity Commission to which they can file a formal complaint.
Employers can maintain high proportions of people vaccinated and still make accommodations for those with sincere religious beliefs, as demonstrated by the Conway Regional Health System.
But allowing religious exemptions on the basis of the conviction of justification, Reiss explained, is problematic because it opens the door for people who have attended anti-vaccine workshops or “people who are just better liars” for. play with the system.
Building confidence in vaccines
According to Williams, the reluctance to vaccinate and the misuse of religious exemptions can be attributed not only to a knowledge gap due to misinformation and misinformation about vaccines, but also to a lack of trust among individuals and public health experts.
“It comes down to something that scares them about the vaccine and they are using the religious exemption as a cover,” Reiss said.
A common concern among opponents of the vaccine is the use of fetal cell lines in vaccine research and development, although this is not an actual ingredient in the vaccine.
Asked about alternatives to curb the spread of misinformation regarding the side effects and composition of vaccines and the misuse of religious exemptions, Williams suggested working with religious and religious leaders with whom individuals have already established their trust.
“All major religious traditions support vaccinations. And they also support all COVID vaccines, ”Williams said. Reverends and bishops across the country have started working with governments to build confidence in the COVID-19 vaccine. It then often boils down to individual interpretations of Scripture that lead to religion-based anti-vaccine beliefs.
According to Williams, facilitating an ongoing conversation between religious leaders, public health experts, and community members would provide a safe space for individuals to voice their concerns and get answers in a comfortable environment.
With its relatively recent appearance, experts agree that it may be too early to talk about the rate of religious exemptions on the deployment of the COVID-19 vaccine mandate.
It’s important to stress how problematic it is to abuse religious exemptions, Reiss pointed out. “Because in a real sense, it’s abusing religion. It’s making fun of true belief and encouraging people to lie about religion, which no religion supports, I think.
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