Few religions ban vaccination, but that counts little for religious exemptions

Coronavirus vaccine mandates are spreading, and with them, pushback based on religion.

In Washington, D.C., about 1,500 city health care workers are seeking exemptions for religious reasons. Over 2,000 Los Angeles Police Department workers have filed a lawsuit objecting on religious or medical grounds. 

When asked on CNN’s "State of the Union" about the number of religions that bar vaccination, infectious disease chief Dr. Anthony Fauci said there aren’t many.

"There are precious few religions that actually say, you cannot do that," Fauci said Oct. 3. "I mean, literally less than a handful."

When host Dana Bash asked about people who said it was a matter of their personal faith, not formal doctrine, Fauci said it would be difficult to sort out who might be using that as an excuse.

We were curious about the official positions on vaccination among organized religions. Fauci’s statement that very few religions ban getting the shot is accurate, but the law is less concerned with what religious doctrine states and more focused on the individual’s conviction and behavior.

Vanderbilt University Medical Center’s review of immunization and religions identified a small subset of Christian faiths that oppose vaccination on theological grounds. There are five, a group that includes the Dutch Reformed Church, Church of the First Born, Faith Assembly and Endtime Ministries. The Vanderbilt list is largely a topline overview, not a comprehensive study of all religions worldwide.

Many people might instantly think of Christian Scientists. While many Christian Scientists rely on prayer for healing, the Christian Science Church offered guidance to its members on vaccines in early 2019. It said that "for more than a century, our denomination has counseled respect for public health authorities and conscientious obedience to the laws of the land, including those requiring vaccination." 

Church leaders impose no decision on church members, but they encourage them to recognize the seriousness of public health concerns.

"Church members are free to make their own choices on all life-decisions, in obedience to the law, including whether or not to vaccinate," the statement said.

Protestant faiths, Islam, Roman and Orthodox Catholicism, Judaism, Hinduism, Jainism, Buddhism, Jehovah’s Witnesses, and more have no prohibition against vaccination. The Vanderbilt survey named 24 religions in this group.

As a counting exercise, Fauci’s statement holds up. But formal doctrine doesn’t drive American law. The Constitution bars the government from getting involved in the establishment of any religion. That would include judging whether a religion held a formal status. Instead, the courts focus on the individual.

"The standard is the sincerity of the personal belief, not whether you're part of an organized religion that prohibits vaccines," said University of California Hastings Law School professor Dorit Rubenstein Reiss.

Like most, if not all, vaccine mandates, the one for Washington, D.C. workers includes an exemption for "sincerely held religious beliefs."

"The problem, of course, is that it can be difficult to disentangle the reasons why someone objects," said Wendy Parmet, a Northeastern University law professor. "States or employers that reject a requested exemption could be vulnerable to litigation." 

What a court has to decide is whether the belief is religious and whether it is sincere.

"A fervently held personal belief can be religious in nature even if it is not endorsed by any recognized or organized religious group," Lindsay Wiley, a law professor at American University. "But not all personal beliefs are religious in nature."

Wiley pointed to a 2020 case when an employee at Children’s Hospital of Philadelphia refused to get a flu vaccine. She was fired and then she sued, saying she had been discriminated against for her religion. The Third Circuit U.S. Court of Appeals didn’t buy it.

In terms of religion, the court wrote that it was looking for beliefs that "address fundamental and ultimate questions having to do with deep and imponderable matters," and "are comprehensive in nature."

The court said the employee had given inconsistent reasons, at one point having said that she thought the vaccine would do more harm than good. That, the court said, was a medical, not religious, belief.

Courts might judge present religious sincerity based on past behavior.

"It's relevant if the person has never refused vaccines in the past," said Michelle Mello, a law professor at Stanford University. 

A history of opposing mask mandates might also weigh against a claim based on religion. A federal court in Pennsylvania ruled against a woman who argued that a mask mandate at her child’s school violated her interpretation of the Bible. She said that she believed that "people are made in the image of God and it therefore dishonors God to cover our faces."

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The judge was unpersuaded about the sincerity of that belief when the woman said she relied on a specific biblical verse, and then was unclear on what the verse said.

For the federal workforce, a group of managers from various agencies developed a questionnaire for federal employees seeking a religious exemption. It aligns very closely with the way courts have assessed religious belief and sincerity.

The template asks employees to explain how getting vaccinated would "substantially burden your religious exercise." It asks how long they have held the specific belief, and whether, as an adult, they have been vaccinated before to prevent such diseases as tetanus or flu. If their religious objection is to the COVID-19 vaccine in particular, the questionnaire asks why this vaccine is different.

Two legal frameworks shape how courts consider the intersection of vaccine mandates and religion. For employers, both private and public, Title VII of the Civil Rights Act is key. That section prohibits discrimation based on religion. 

When mandates apply to non-employment situations, such as school and college campus requirements, the Constitution and the right to the free exercise of religion is more important. And there are instances, such as state-level policies, where both the Civil Rights Act and the Constitution can apply.

Under the Civil Rights Act, employers must offer a "reasonable accommodation" for a sincerely held religious belief. An accommodation is reasonable, so long as it doesn’t impose an "undue hardship" on the firm.

"Undue hardship is defined in Title VII in quite an employer-friendly way," said Mello at Stanford Law School. "If it's more than a minimal burden on business operations, the employer can decline to provide any accommodation."

The legal experts we reached said the present interpretation of the constitutional guidelines is less clear cut.

"Ordinarily, an epidemic would justify restrictions that burdened religious beliefs somewhat, but the current majority of Supreme Court justices seem to be indicating that there are almost always accommodations that the government can give to religious practices," said Wendy Mariner, a Boston University law professor.

Mariner highlighted the 2021 U.S. Supreme Court ruling against California’s limits on religious gatherings. The majority wrote that the state "has not shown that ‘public health would be imperiled’ by employing less restrictive measures."

Fauci said that very few religions prohibit vaccination. A survey of religious beliefs by Vanderbilt University backs that up. The survey named five religions that stand against vaccinations, and 24 that accept them.

Fauci acknowledged that assessing a person’s religious beliefs can be complicated. The standard for American courts is not a formal stance by a religious organization but whether a person’s belief is genuinely religious and sincere. 

Fauci’s statement is correct, but there’s a lot more to unpack.

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