New York’s repeal of the religious exemption from school vaccination requirements is still in force. Since June 13, 2019, parents in New York have not been able to opt their children out of required school immunizations on religious grounds; the only exemption available is a medical one, documented annually by a New York-licensed physician. That rule survived years of state and federal court challenges, but a December 2025 order from the U.S. Supreme Court has sent one case back to a federal appeals court for another look, and the outcome could reshape what exemptions are available.
What the 2019 Law Changed
New York’s school vaccination mandate lives in Public Health Law § 2164. Before 2019, it allowed parents to opt out based on “genuine and sincere religious beliefs.” Senate Bill 2994A, sponsored by Senator Brad Hoylman-Sigal and signed by Governor Andrew Cuomo on June 13, 2019, struck that language. The law took effect immediately, in the middle of a measles outbreak that produced roughly 1,000 confirmed cases in New York between October 2018 and mid-2019, with clusters in Rockland County and parts of Brooklyn.
Children who had held a religious exemption were required to receive the first dose of each age-appropriate vaccine series by June 28, 2019, with proof of scheduled follow-up appointments due by July 14, 2019. Schools that continued to admit noncompliant students without a valid medical exemption faced civil penalties.
The mandate applies to all K–12 public, private, and parochial schools, as well as preschools, daycare centers, and special education programs. Colleges and universities are not covered.
The Vaccines Required
For the 2025–2026 school year, New York requires vaccination against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B, varicella, meningococcal disease, Hib, and pneumococcal disease. Specific dose requirements vary by grade level.
Students who are not fully vaccinated and not “in process” (meaning they have received the first dose and have appointments scheduled for the remaining doses) must be excluded from school. During a disease outbreak, even students with a valid medical exemption or in-process status can be temporarily removed.
The Only Remaining Opt-Out: Medical Exemptions
A medical exemption is the sole way to keep an unvaccinated child in a New York school. The Department of Health tightened the standards shortly after the repeal, through emergency regulations enacted on August 16, 2019.
Under those rules, a signed doctor’s note is not enough. A New York-licensed physician must complete a government-approved exemption form, identify a specific medical contraindication consistent with guidance from the Advisory Committee on Immunization Practices, submit patient information to the statewide Immunization Information System within 14 days of an in-person clinical visit, and renew the exemption every year. Schools themselves decide whether to accept or deny each medical exemption form.
The tighter standards were designed to prevent medical exemptions from becoming a substitute for the eliminated religious exemption. State officials pointed to California, where medical exemption rates more than tripled in the three years after that state removed non-medical exemptions in 2015. In New York, the same shift did not happen: by the 2023–2024 school year, the overall exemption rate was about 0.1%, according to CDC data.
The Supreme Court’s December 2025 Order in Miller v. McDonald
The most important legal development for New York parents came on December 8, 2025, when the U.S. Supreme Court granted certiorari, vacated the Second Circuit’s decision in Miller v. McDonald, and remanded the case “for further consideration in light of Mahmoud v. Taylor.” The Court did not hear oral argument or issue a written opinion. This procedural step, known as a GVR, is a signal that the Justices believe a recent decision could change the lower court’s analysis.
Miller is a challenge brought by three Old Order Amish parents (Joseph Miller, Ezra Wengerd, and Jonas Smucker) and three private Amish schools (Dygert Road School, Pleasant View School, and Shady Lane School) against New York Health Commissioner James V. McDonald and other state officials. The plaintiffs frame it as an “applied challenge” specific to the Amish, whose faith requires separation from modern society, private religious education, and rejection of vaccination. In 2022, the state began enforcing the amended law against the three schools, imposing fines totaling roughly $118,000 under a provision allowing penalties of up to $2,000 per violation, with each day an unvaccinated student attended school treated as a separate violation.
U.S. District Judge Elizabeth Wolford in the Western District of New York dismissed the complaint. On March 3, 2025, a Second Circuit panel of Judges Jose Cabranes, Richard Wesley, and Eunice Lee affirmed. The panel held that Public Health Law § 2164 is a “neutral and generally applicable law” satisfying rational basis review, found no evidence of legislative hostility toward religion, and ruled that medical exemptions are “mandatory” and “objectively defined,” so they do not create the kind of individualized discretion that would trigger heightened scrutiny. The panel also distinguished the case from Wisconsin v. Yoder, finding that the mandate did not pose the “existential threat” to the Amish way of life that Yoder addressed.
The Supreme Court’s December order wipes out that judgment. The Second Circuit must now decide the case again under the framework of Mahmoud v. Taylor. As of mid-2026, the court had not scheduled new arguments or issued a ruling.
Why Mahmoud v. Taylor Matters
Mahmoud v. Taylor, decided 6–3 on June 27, 2025, involved parents in Montgomery County, Maryland who objected on religious grounds to LGBTQ-inclusive storybooks in the elementary school curriculum. Writing for the majority, Justice Alito held that when a government policy “substantially interferes with the religious development” of children, strict scrutiny applies even if the policy is neutral and generally applicable on its face. The Court ordered the school board to provide notice and allow parents to opt their children out of the challenged instruction. The Montgomery County board later entered a consent judgment paying $1.5 million in damages and agreeing to ongoing opt-out procedures.
The relevance to New York is straightforward. The Second Circuit affirmed the repeal by applying rational basis review to a neutral, generally applicable law. If Mahmoud‘s framework extends to vaccination, and if forcing Amish families to vaccinate their children counts as substantial interference with religious development, the state would have to satisfy strict scrutiny instead. That means showing the mandate is narrowly tailored to serve a compelling interest, a much harder standard.
A Harvard Law Review analysis noted that the GVR places the Second Circuit in a difficult position: longstanding precedent has treated public health mandates as an outer boundary of religious liberty claims, but the Supreme Court’s order suggests that boundary is being reconsidered. Whether the appeals court reaches the same result under a new framework, or rules for the Amish plaintiffs, is now the open question.
What a Ruling for the Plaintiffs Would Mean
Miller is framed as an applied challenge specific to the Amish, not a facial attack on the statute. A win for the plaintiffs on remand would not automatically restore a general religious exemption for every New York family; it could, depending on the court’s reasoning, produce a narrower ruling requiring accommodation for the Amish plaintiffs and similarly situated communities. A broader ruling is possible but not required by the case’s posture.
Earlier Challenges That Failed
Before Miller, the main challenge to the repeal was F.F. v. State of New York, a class action filed in Albany County Supreme Court on July 10, 2019 by a group of parents who alleged violations of the Free Exercise Clause, the Equal Protection Clause, and their state constitutional rights, and argued the repeal was motivated by religious animus.
Every stage went against the challengers. Justice Mackey denied a temporary restraining order on July 12, 2019. Justice Denise A. Hartman denied a preliminary injunction on August 23, ruling that the law was a “neutral law of general applicability” and that community immunity served a compelling state interest. On December 3, 2019, Justice Hartman granted the state’s motion to dismiss, finding that isolated statements by individual legislators did not amount to religious animus and that the law would survive even under strict scrutiny. The Appellate Division’s Third Department affirmed. The plaintiffs asked the U.S. Supreme Court to hear the case in January 2022, and the Court declined on May 23, 2022.
Until the December 2025 GVR order, that string of losses left the repeal on solid legal ground.
Chances of Legislative Restoration
Senator Patrick M. Gallivan has introduced bills to restore the religious exemption in every session since the repeal. The current version, Senate Bill S266 for the 2025–2026 session, would re-add a provision allowing parents with “genuine and sincere religious beliefs” contrary to vaccination to opt their children out. The bill has twelve co-sponsors, all Republicans or Conservatives, and sits in the Senate Health Committee, where it was referred on January 7, 2026. Identical bills in prior sessions never advanced beyond the same committee.
The Assembly companion, A1358, sponsored by Assemblymember DiPietro with nineteen co-sponsors, has not fared any better. On May 19, 2026, the Assembly Health Committee voted 14–8 to hold the bill for consideration, effectively blocking it from reaching the floor. With Democrats holding large majorities in both chambers, a legislative restoration is not a realistic path in the current session.
What This Means for Parents Right Now
For the 2025–2026 school year, the answer is unchanged. A religious exemption is not available. If your child cannot be vaccinated for a specific medical reason recognized by ACIP guidance, a New York-licensed physician can complete the state-approved medical exemption form, upload the required information to the state Immunization Information System within 14 days of an in-person visit, and renew the exemption every year. The school then reviews the form and decides whether to accept it.
If your child has neither a completed medical exemption nor documentation showing the vaccine series is in process, the school must exclude the child. In an outbreak, exclusion can extend even to children with valid medical exemptions or in-process status.
The Miller reconsideration is worth watching. A ruling for the plaintiffs could open a path to religious accommodation for at least some families, but no such ruling has issued, and any change would take effect only after the Second Circuit acts. Until then, the 2019 repeal stands, and the medical exemption is the only opt-out New York recognizes.