Constitutional – District court erred when it excused minor from vaccination law

Where the district court issued an injunction allowing a minor’s parents a religious exemption from West Virginia’s compulsory vaccination law, it erred.

Background

Anthony and Krystle Perry brought this suit on behalf of their daughter to obtain a religious exemption from West Virginia’s compulsory vaccination law. Religious exemptions are not available under state law, but the Perrys claim they are required by the First Amendment. After finding that the Perrys were likely to succeed on the merits of their free exercise claim, the district court granted them a preliminary injunction.

Analysis

West Virginia legitimately exercised its police power to protect the health and well-being of school children when it enacted its compulsory vaccination law. West Virginia has a legitimate—indeed, compelling—interest in reducing the spread and severity of infectious diseases.

Vaccines are not just rationally related to reducing the spread and severity of infectious diseases, they are specifically designed to do so. Deaths caused by the diseases covered by West Virginia’s law have also been significantly reduced since vaccines were first developed. For these reasons, a state’s interest in vaccinating its citizens and protecting its school children has long been recognized as of the utmost importance.

The district court erred in reaching the opposite legal conclusion. In its view, West Virginia’s compulsory vaccination law is not generally applicable because the process for granting medical exemptions involves “significant individualized discretion.” This court cannot agree. Determining whether a child qualifies for a medical exemption may require some degree of professional judgment, but that is not the kind of unfettered discretion that undermines the general applicability of a law.

West Virginia’s compulsory vaccination law does not provide a mechanism for granting individualized exemptions. State officials do not have any discretion “to decide which reasons” for refusing vaccination “are worthy of solicitude.” The law recognizes only one kind of exemption—medical exemptions—and clearly articulates the circumstances in which state officials can grant them: when there is “sufficient medical evidence” that a child’s “physical condition . . . is such that immunization is contraindicated or there exists a specific precaution to a particular vaccine.” To the extent state officials must exercise discretion when deciding whether sufficient medical evidence exists in a particular case, it is cabined by judicial review.

If it were otherwise, then there would be no limiting principle. Every legal standard or criterion that required some degree of professional judgment in its application would suddenly run afoul of the Free Exercise Clause. This cannot be. Indeed, as far as this court is aware, every circuit court that has considered the issue has held that medical exemptions to compulsory vaccination laws are not “mechanisms for individualized exemptions.”

The two cases cited by the Perrys are not on point. In both cases, the court held only that a compulsory vaccination policy lacked general applicability because it permitted university officials to grant religious exemptions on an individualized basis. West Virginia’s law does not permit religious exemptions of any kind. Finally, the Perrys ask this court to affirm the district court’s decision on three alternate bases. None are persuasive.

Reversed and remanded.

Dissenting opinion

Nieyemer, J., dissenting:

The injunction entered here hardly affects West Virginia’s compelling interest in preventing the spread of infectious disease, as the injunction treats virtual students the same as other West Virginia students not physically attending a school while, at the same time, preserving the Perrys’ free exercise rights. Moreover, since the district court entered the preliminary injunction in this case, the Supreme Court has issued opinions that confirm the district court’s decision and, indeed, command such an injunction. I would affirm.

Perry v. Marteney, Case No. 24-2132, April 8, 2026. 4th Cir. (Wilkinson), from NDWVA at Elkins (Kleeh). William M. Lorensen for Appellants. Christopher David Wiest for Appellees. VLW 026-2-119. 38 pp.

Full-Text Opinion

VLW 026-2-119
Virginia Lawyers Weekly