Supreme Court Won’t Block Maine’s Vaccine Mandate for Health Care Workers

A state regulation that does not allow exemptions on religious grounds was challenged by workers who said taking a coronavirus vaccine was at odds with their faith.

A mobile coronavirus testing site in Auburn, Maine, last year. The court’s three most conservative justices dissented from a ruling leaving the state’s vaccine mandate for health care workers in place. 
Credit…Robert F. Bukaty/Associated Press

Adam Liptak

WASHINGTON — The Supreme Court on Friday refused to block Maine’s requirement that health care workers be vaccinated against the coronavirus notwithstanding their religious objections.

As is the court’s custom in rulings on emergency applications, its brief order gave no reasons.

But the three most conservative members of the court — Justices Clarence Thomas, Samuel A. Alito Jr. and Neil M. Gorsuch — issued a lengthy dissent, saying the majority had gone badly astray.

“Where many other states have adopted religious exemptions, Maine has charted a different course,” Justice Gorsuch wrote for the dissenting justices. “There, health care workers who have served on the front line of a pandemic for the last 18 months are now being fired and their practices shuttered. All for adhering to their constitutionally protected religious beliefs. Their plight is worthy of our attention.”

The court had earlier rejected challenges to vaccination requirements at Indiana University and for personnel in New York City’s school system. Those rulings were issued by just one justice, which can be a sign that the legal questions involved were not considered substantial.

But those earlier rulings did not involve religion. The court has in other settings been quite protective of religious practices, even when they seemed at odds with public health. It has, for instance, repeatedly blocked state shutdown orders that treated houses of worship less favorably than what the justices in the majority said were comparable secular activities.

Friday’s ruling was, at least in that sense, something of a surprise.

Justice Amy Coney Barrett, joined by Justice Brett M. Kavanaugh, filed a brief concurring opinion. She said the court should be wary of making momentous decisions “on a short fuse without benefit of full briefing and oral argument.”

The concurrence seemed to have a dual purpose: of indicating that the two justices were not signaling how they would vote if the question reached the court in a more deliberate fashion and of cautioning litigants against the overuse of what critics call the court’s “shadow docket.”

Maine has required health care workers to be vaccinated against various contagious diseases since 1989, and eliminated exemptions on religious or philosophical grounds under a state law enacted in 2019, before the coronavirus pandemic began. The state does exempt workers for whom the given vaccine would be “medically inadvisable” in the judgment of a health care professional.

The 2019 law was the subject of a referendum, with about 73 percent of the state’s voters approving it.

The state included a coronavirus vaccine among the required vaccinations in a regulation issued in August, setting a deadline of Oct. 29. Several health care workers sued, saying the requirement violated their constitutional right to the free exercise of religion.

Judge Jon D. Levy of the Federal District Court in Maine ruled against the plaintiffs.

“Both the serious risk of illness and death associated with the spread of the Covid-19 virus and the efforts by state and local governments to reduce that risk have burdened most aspects of modern life,” he wrote.

The plaintiffs’ “refusal to be vaccinated based on their religious beliefs has resulted or will result in real hardships as it relates to their jobs,” Judge Levy wrote. “They have not, however, been prevented from staying true to their professed religious beliefs which, they claim, compel them to refuse to be vaccinated against Covid-19.”

A unanimous three-judge panel of the U.S. Court of Appeals for the First Circuit, in Boston, affirmed Judge Levy’s ruling.

Judge Sandra L. Lynch, writing for the panel, said the regulation did not single out religion for disfavored treatment. In a 1990 decision, the Supreme Court ruled that neutral laws of general applicability that incidentally impose burdens on religion generally do not run afoul of the First Amendment’s protection of religious liberty. That decision, Employment Division v. Smith, has been the subject of harsh criticism by the more conservative members of the Supreme Court.

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The plaintiffs in the case from Maine said the state was an outlier in refusing to grant religious exemptions.

“Almost every other state,” they told the justices, “has found a way to protect against the same virus without trampling religious liberty — including states that have smaller populations and much greater territory than Maine. If Vermont, New Hampshire, Alaska, the Dakotas, Montana, Wyoming, California and the District of Columbia can all find ways to both protect against Covid-19 and respect individual liberty, Maine can too.”

The plaintiffs also argued that the state’s regulation was not generally applicable because it allowed for medical exemptions. Judge Lynch rejected that argument, saying the medical exemption was in keeping with the goals the regulation meant to accomplish. “Providing health care workers with medically contraindicated vaccines would threaten the health of those workers and thus compromise both their own health and their ability to provide care,” she wrote.

In an emergency application urging the Supreme Court to intervene, lawyers for the workers wrote that “untold numbers of employees in Maine will have to decide, in a matter of days, what is more important to them — their deeply held religious beliefs or their ability to work anywhere in their state so that they can feed their families.”

Aaron M. Frey, Maine’s attorney general, responded that the plaintiffs “have not fairly stated their choices.”

“They remain free to decline vaccination in accordance with their religious beliefs,” Mr. Frey wrote, adding that they “can pursue employment elsewhere or may be transitioned to employment off site.”

Maine, he wrote, is “seeking to protect the health and lives of health care workers and patients across the state, and that interest far outweighs the harm, if any, that applicants may suffer.”

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Adam Liptak