Mazer v. D.C. Department of Health
Civil Action No. 2021-1782
| D.D.C. | Mar 18, 2022Background
- In 2020 D.C. enacted the Minor Consent for Vaccinations Act Amendment (MCA), letting minors age 11+ consent to ACIP‑recommended vaccines if they meet an informed‑consent standard and adding D.C. "age‑appropriate alternative" vaccine information sheets.
- The MCA directs providers to bill insurers directly (and not send EOBs for MCA vaccinations), allows minors access to their immunization records, and requires providers to leave part 3 of the D.C. Universal Health Certificate blank where a parent filed a religious exemption, sending the immunization record confidentially to the school (but not permitting parental access). That concealment requirement does not apply to medical exemptions.
- Plaintiffs are parents who assert sincere religious objections (the Booth parents and Joshua Mazer on behalf of his daughter J.D.). They challenge the MCA under 42 U.S.C. § 1983, alleging (inter alia) that the MCA is preempted by the National Childhood Vaccine Injury Act (NCVIA) and that the MCA violates Free Exercise and RFRA.
- The district court found plaintiffs had standing (based on imminent likelihood that minors L.B. and J.D. would seek vaccinations) and granted preliminary injunctive relief: enjoining implementation of the MCA as to the preemption claim for all plaintiffs and as to the Free Exercise claim for the Booth parents.
- The court’s legal reasoning: (1) conflict preemption — the NCVIA requires providing federal Vaccine Information Statements (VIS) to a child’s legal representative, and the MCA (by enabling minor self‑consent and substituting/obscuring VIS and vaccination records) conflicts with that federal scheme; (2) Free Exercise — the MCA is not neutral/generally applicable because it singles out religious exemptions for differential treatment versus medical exemptions, triggering strict scrutiny which MCA did not satisfy on the record.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether NCVIA preempts the MCA | MCA cuts parents out of vaccination process and prevents parents from receiving the VIS required by NCVIA | MCA permits giving the VIS to the mature minor (so no conflict); state minor‑consent norms should define “child” | Court: NCVIA likely preempts MCA by conflict; "child" should be read in ordinary sense and MCA’s alternative VIS and concealment create impossible dual compliance |
| Whether MCA violates Free Exercise (Booth parents) | MCA targets religious parents by blanking Certificate part 3 only when a religious exemption is filed, disadvantaging religious parents relative to medical exemptions | MCA is neutral; government need not provide religious exemptions; any burden is minor or justified by public‑health interests | Court: MCA is not neutral/generally applicable, likely violates Free Exercise; strict scrutiny applies and District has not shown narrow tailoring |
| Standing to bring preemption and Free Exercise claims | Parents: imminent injury because minors (L.B., J.D.) likely to seek vaccines; NCVIA conflict causes informational and statutory injury | District: alleged future vaccination is speculative; consent/clinic and provider discretion make injury non‑imminent | Court: Plaintiffs (Booth and Mazer) have standing for preemption; Booth has standing for Free Exercise (based on imminent risk and statutory conflict) |
| Preliminary injunction (irreparable harm, equities, public interest) | Irreparable harm: loss of statutory rights and loss of First Amendment freedoms; vaccination is irreversible | District: public‑health interests and vaccination promotion favor denial | Court: Plaintiffs shown irreparable harm; balance of equities and public interest favor injunction at this stage |
Key Cases Cited
- Bruesewitz v. Wyeth LLC, 562 U.S. 223 (2011) (describing NCVIA structure and congressional purpose in creating a uniform federal vaccine‑injury scheme)
- Wyeth v. Levine, 555 U.S. 555 (2009) (presumption against preemption where states traditionally regulate)
- PLIVA, Inc. v. Mensing, 564 U.S. 604 (2011) (conflict preemption where compliance with both federal and state law is impossible)
- Miss. Band of Choctaw Indians v. Holyfield, 490 U.S. 30 (1989) (when federal statute uses familial terms, guidance on when to consult state law)
- De Sylva v. Ballentine, 351 U.S. 570 (1956) (domestic relations and limits on importing state definitions into federal law)
- Lukumi Babalu Aye, Inc. v. City of Hialeah, 508 U.S. 520 (1993) (law lacks neutrality/general applicability when it targets religion)
- Fulton v. City of Philadelphia, 141 S. Ct. 1868 (2021) (selective exemptions can defeat general applicability and trigger strict scrutiny)
- Masterpiece Cakeshop v. Colorado Civil Rights Comm'n, 138 S. Ct. 1719 (2018) (government hostility to religion is constitutionally problematic)
- Clapper v. Amnesty Int'l USA, 568 U.S. 398 (2013) (standing requires injury that is certainly impending, not speculative)
- Winter v. Natural Resources Defense Council, Inc., 555 U.S. 7 (2008) (preliminary injunction standard: likelihood of success, irreparable harm, balance of equities, public interest)