Two lawsuits filed in District of Columbia federal court this month challenged a city law passed last year that allows minors to be vaccinated without their parents’ knowledge, saying the legislation violates religious liberty.
The litigation comes as health officials across the country debate how much information minors should be given about vaccines, with at least one state seeking to limit teenagers' access to shots that would protect them from the coronavirus and other illnesses.
In October, the District passed the Minor Consent to Vaccinations Amendments Act, which allows children as young as 11 to get vaccines without their parents' knowledge if a doctor determines that they are capable of informed consent.
The law was passed before coronavirus vaccines became available and was meant to allow teenagers to get shots such as the HPV vaccine, which protects against a sexually transmitted infection that can cause cancer, and the meningitis vaccine, which is recommended for teens.
On Monday, four parents of children who attend or planned to enroll at D.C. public and charter schools sued Mayor Muriel E. Bowser and other public officials, saying the law “subverts the right and duty of parents to make informed decisions about whether their children should receive vaccinations.”
The lawsuit, filed in US District Court for the District of Columbia, cited parents’ religious objections to coronavirus vaccines and other immunizations. It said the law violates their religious liberty and “their fundamental right to direct the care and upbringing of their children.”
The parents fear that, if they send their children to D.C. public schools in person, their children will be pressured by teachers and peers to seek vaccinations without their parents' knowledge, according to the suit.
A spokeswoman for Bowser said the city could not comment on pending litigation. The law was enacted last year without the mayor's signature.
The lawsuit did not identify the religious affiliation of the parents who say that it would violate their faith if their children were immunized. No major American religious group says that children should not get vaccines, but many states allow parents to opt their children out of the shots if the parents claim a personal faith-based objection.
Catholic bishops have raised concerns about some versions of the coronavirus vaccine, though not about recommended childhood vaccines generally.
Jessie Hill, a Case Western Reserve University law professor who has written on children's legal rights to make some medical decisions for themselves, said that if the D.C. cases make it to court, they might pose novel questions on whether parents can impose their religious beliefs on children who disagree.
“This is a whole uncharted territory — does the parent have a religious right essentially to override the child’s religious beliefs?” she said. “We have this big question mark about whether parents, especially when the minor is considered mature and able to make their own decisions . . . still have a right, at that point, to exempt them on religious grounds.”
Because the D.C. law allows health-care providers to leave students' immunization records blank, the lawsuit said, it helps create "a separate record that does contain vaccines administered under the Act, but which cannot be transmitted to a parent."
The lawsuit, which asked the court to declare the law unconstitutional and stop the city from enforcing it, was brought by Children’s Health Defense, an organization run by antivaccine activist Robert F. Kennedy Jr., who has supported debunked vaccine conspiracy theories and is listed as an attorney on the complaint.
The suit followed another, also filed in D.C. federal court, by a Maryland man who said his daughter sought a vaccine in the District without his knowledge and despite his religious objections to vaccines.
The plaintiff's daughter, now 16, suffered a "severe reaction" to a vaccine when she was 5 years old, according to the suit. However, in April, she went to MedStar Georgetown Pediatrics to get a vaccine for tetanus, diphtheria, and pertussis so she could attend camp, the suit said.
At MedStar, a doctor “coached [her] on lying in relation to receiving the shots,” according to the lawsuit, which was filed July 2. When the teenager became nervous and decided not to get vaccinated, “the doctor and nurse positioned themselves in the room such that she felt trapped” before she was able to leave without receiving any vaccines.
In an e-mail, MedStar Georgetown University Hospital spokeswoman Lisa C. Clough said the institution was not a party to the lawsuit. She declined to comment on an individual patient’s treatment.
"MedStar Georgetown Pediatrics is committed to providing world class, compassionate care to all of our patients," she said. "We follow all applicable laws regarding the administration of vaccines."
The suit asked the court to declare the Minor Consent to Vaccinations Amendment Act unconstitutional, saying it "creates an entire structure by which the health care provider, insurance company, school, and health department all engage in an elaborate and deceitful scheme."
The lawsuits were filed as the nation debates how much vaccine access children should have without their parents' knowledge and whether they should get information about vaccines at all.
Tennessee, for example, fired its top immunization official Monday amid a debate about vaccine access. Michelle Fiscus, former director of immunization programs at the Tennessee Department of Health, said she was terminated for making plans to vaccinate teenagers against the coronavirus. The Centers for Disease Control and Prevention recommends that everyone age 12 or older get the coronavirus vaccine.
Children’s independent access to vaccines varies widely by state. Some states allow minors to get vaccinated without parental consent only when they are seeking the HPV vaccine, not other immunizations recommended for their age. Some states allow youths to make independent medical decisions at certain ages, such as 16 and up, but not as young as the D.C. law.
Richard Redding, a doctor and lawyer who teaches at Chapman University, said that courts have consistently upheld state laws that allow teens to make their own medical decisions in certain circumstances, such as those that allow minors to seek treatment for anxiety or depression even when a parent objects to psychotherapy.
"We know from a lot of research over a number of decades that your average [teenager] has the competence . . . to be able to provide and form consent to basic medical procedures, including things like whether or not to get a vaccine," he said.
Redding and Hill both noted that a judge may decide the parents in the two D.C. lawsuits do not have standing to even advance their cases. The judge may say that the claimants would need to prove an actual injury — in other words, that their child actually received a vaccine — to move forward.