Court of Appeals upholds New York State measles vaccination requirements

We have another vaccination ruling from the Court of Appeals, but this one does not involve Covid-19 but measles. A few years ago, the State of New York revised its measles vaccination rules, narrowing but not limiting the medical exemption for children who cannot medically tolerate a measles shot. Plaintiffs argue that these rules violate due process because they allow school districts to override the medical certifications submitted by the students' doctors.  The Court of Appeals disagrees and the state procedures remain on the books.

The case is Goe v. Zucker, issued on July 29. Since the school districts rejected the certifications submitted by the plaintiff-students' doctors, some were expelled and others enrolled in private schools. Plaintiffs offer a series of constitutional argues dealing with fundamental rights to education, and their right to a medical exemption. The Court of Appeals (Leval, Cabranes and Chin) does not see it that way.

First, the Court says, the state is not forcing any child to be vaccinated against her parents' will. Instead, the new regulations permit a medical exemption under certain circumstances, and the parents and their doctors have to comply with evidence-based national standards to ensure that doctors do not recommend medical exemptions in conclusory fashion or for non-medical reasons. In this case, the Court says, some exemptions were denied because the doctors did not provide thorough information in support of the exemption requests. In other instances, the school districts relied on the opinion of the district physicians rather than the students/parents' physicians. Read that again: school district doctors could enforce their second opinion on the students. Nor is there any fundamental right to have a medical exemption based solely on the students/parents' physicians. 

What about the fundamental right to an education? You may be surprised to know there is no such fundamental right under the Constitution, which does not mention education at all; the Supreme Court said this in 1973. And, the Court says, "no court appears ever to have held" that the Constitution requires strict scrutiny (the most difficult legal standard to overcome in American law) in reviewing immunization mandates. With all the talk about substantive due process in the past few months in the abortion and family planning context, there has been almost not talk about the lack of any fundamental right to an education under the Constitution. 

Since the state regulations do not implicate a fundamental right, the Court applies the rational basis test, which is highly deferential to governmental decisionmaking. The state meets this test because it has a legitimate need to vaccinate students to prevent the spread of measles. We had an outbreak in 2018-19 and the state doesn't want a repeat performance. The state regulations are also reasonably related to this objective, the Court says, because they conform to national medical exemption standards and prevent parents from obtaining illegitimate medical exemptions following the religious exemption repeal a few years ago. The state may also delegate to school districts the authority to grant or deny these medical exemptions; that process is also rationally related to the state's interest in regulating measles and other viruses.