The Second Circuit earlier this week upheld New York’s school vaccination requirement, which includes a medical exemption but not a religious one.
The ruling means that New York can continue to enforce its vaccination requirement even against those who have a religious objection.
Sooner or later, the issue seems likely headed to the Supreme Court. (The Second Circuit’s ruling aligns with the Fourth Circuit.)
The case, Miller v. McDonald, arose when Amish parents and schools sued the state over its vaccination requirement and lack of a religious exemption, arguing that the law violated their free-exercise right and their right to parent their children consistent with their religious beliefs. New York law previously included both a medical exemption and a religious exemption, but it dropped its religious exemption in 2019, after measles outbreaks in low-vax-rate communities.
This is the second time the Second Circuit considered the case. The court previously upheld New York’s law against the same challenge. But the Supreme Court vacated that earlier judgment and remanded the case for reconsideration in light of Mahmoud v. Taylor (2025). Mahmoud held that a school board violated parents’ rights to direct their children’s religious upbringing by refusing to allow parents to opt their children out of instruction that included messages contrary to the parents’ religious beliefs.
The Second Circuit applied Mahmoud to the plaintiffs’ right-to-parent claim and again upheld New York’s vax requirement against both claims.
As to the free-exercise claim, the court held that the requirement was a neutral law of general applicability, and, even though it had an “incidental” effect on religion, it only needed to clear a low bar, rational-basis review. The court rejected the plaintiffs’ claim that the medical exemption (and the state’s withdrawal of the religious exemption) meant that the state treated comparable secular conduct more favorably than religious conduct, making the law biased against religion (and not neutral). It also rejected their claims that the medical exemption required an individualized assessment that would make the law not generally applicable. The court noted that even the plaintiffs conceded that the law satisfied rational basis review, and it therefore didn’t violate free exercise.
As to the parental-right claim, the court held that the New York law didn’t burden parents’ rights the same way that the instruction and lack of exemption in Mahmoud burdened parents’ rights. That is, the New York law didn’t interfere with the parents’ right to direct their children’s religious upbringing; instead, it “imposes a health-and-safety condition on in-person school attendance to reduce the spread of communicable disease.” The court said that Mahmoud therefore didn’t change its earlier conclusion: the New York vax law, sans religious exemption, is valid.