RFK Jr. targets one of the strongest state school vaccine mandate laws

The Trump administration is urging West Virginia to offer religious exemptions from school vaccine mandates, alarming public health advocates who see it as part of a broader campaign to undermine an effective immunization strategy.

West Virginia, which has one of the nation’s strictest vaccine mandates, has been embroiled in a dispute over Gov. Patrick Morrisey’s (R) demand to let parents decline shots for their children by invoking their religious beliefs.

The U.S. Department of Health and Human Services backed the governor’s efforts last week by sending a letter to West Virginia officials warning the state may be violating civil rights laws. HHS Secretary Robert F. Kennedy Jr., a critic of vaccine mandates who founded an anti-vaccine organization, followed up with an X post supporting Morrisey and vowing to “defend every family’s right to make informed health decisions.”

Anti-vaccine organizations that have been waging a legal battle to force states to allow religious exemptions praised HHS for getting involved. Some proponents for vaccination say the federal government is overstepping.

Both groups see the administration’s approach to West Virginia as unprecedented and a sign other states may be next.

“HHS is testing the waters of what they can do in regards to influencing state decisions regarding school entry vaccine mandates,” said Madison Harden-Stein, an assistant research professor at Georgetown University’s McCourt School of Public Policy who has tracked the mandates. “I wouldn’t be surprised if it decided to publish similar letters.”

Every state has laws requiring certain vaccines for students to attend school. West Virginia is among five that do not allow any nonmedical exemption, including California, New York, Connecticut and Maine.

Shortly after taking office in January, Morrisey ordered the state to allow people to claim religious exemptions, but other officials have resisted. The GOP-controlled state House narrowly rejected a bill that would have made religious exemptions part of state law. Members of the state Board of Education unanimously maintained that the agency will not offer religious exemptions. Two lawsuits on the issue are now winding through West Virginia courts.

Kennedy — a longtime vocal vaccine critic — on Monday urged state lawmakers to side with Morrisey. “His executive order upholds West Virginians’ religious freedom and parental rights while keeping the state in full compliance with federal law,” Kennedy said in an X post.

HHS “will enforce conscience protections,” Kennedy added.

Days before, the federal health agency sent a letter to West Virginia health officials, noting the lack of a religious exception in its school vaccine mandate and urging the state to make “good faith efforts to ensure it and its health care providers comply with our nation’s robust protections for religion and conscience.” The letter invoked the state’s participation in the Vaccines for Children program, a federally funded initiative that provides shots to children without insurance coverage.

The letter is meant to remind West Virginia of its obligations for participating in the vaccine program, an HHS spokesperson said in an email. It does not mean West Virginia is failing to comply with the rules and or that the state is under investigation, added the spokesperson, who declined to be named.

Del Bigtree, CEO of Informed Consent Action Network, an anti-vaccine organization that opposes vaccine mandates, described HHS’s intervention in West Virginia as “historic.”

“We also know the president of the United States supports freedom of choice when it comes to medical decisions,” said Bigtree, who worked on Kennedy’s 2024 presidential campaign as communications director. “This is what we expected from this administration. This is what we were hoping for.”

Dorit Reiss, a vaccine law analyst, described the letter as political posturing, but significant because she cannot recall the federal health agency ever pressuring a state to weaken a vaccine mandate.

“Kennedy is looking to revisit vaccines, looking to reduce vaccine rates and looking to make it easier for parents to not vaccinate,” said Reiss, professor of law at University of California San Francisco. “He is trying to weaken school immunization requirements.”

An HHS spokesperson said the agency’s efforts are “about protecting conscience and religious freedom rights.”

Anti-vaccine organizations have spent years advancing a campaign to chip away at vaccine mandates and widen exemptions.

Informed Consent Action Network is funding one of the West Virginia lawsuits. The organization successfully sued to create a religious exemption in Mississippi, which, like West Virginia, has long boasted one of the nation’s highest vaccination rates for kindergartners.

The group’s political arm has written model legislation to expand vaccine exemptions. Children’s Health Defense, the anti-vaccine nonprofit Kennedy formerly led before becoming secretary, is championing similar model legislation to “end this persecution” of banning religious exemptions.

The federal health agency’s letter to West Virginia could offer a “path forward” for other states without religious exemptions, Children’s Health Defense CEO Mary Holland said in an article published on her organization’s website.

HHS declined to comment on whether it was scrutinizing those other states.

The expansion of vaccine mandate exemptions would have dire consequences, American Medical Association President Bobby Mukkamala said in a statement.

“At a time of eroding public confidence in vaccines, particularly with measles outbreaks impacting communities across the U.S., allowing non-medical vaccine exemptions as a matter of religious, philosophic or personal belief will further exacerbate vaccine-preventable illnesses,” Mukkamala said, adding that nonmedical exemptions “endanger both those who choose not to — and those who want to but cannot — get vaccinated.”

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• Lauren Weber contributed.