Two groups filed a lawsuit against West Virginia’s state Department of Health, its Bureau for Public Health and agency leaders on Friday, challenging Gov. Patrick Morrisey’s January executive order, which opened the door for religious and philosophical exemptions to mandatory school vaccination policies. The American Civil Liberties Union’s West Virginia chapter and Mountain State Justice filed the suit in Kanawha County Circuit Court on behalf of two parents with immunocompromised children, according to reporting by

Just over 330 requests for religious and philosophical exemptions to West Virginia’s school vaccine policy have been submitted — and approved — for this school year and 35 have been granted for the coming year, according to records obtained by ����Ӱ��.

The newly approved religious and philosophical exemptions already outpace the 203 permanent medical exemptions granted in the state over the past decade, at one time the only exemptions allowed in West Virginia.

Before January, when Gov. Patrick Morrisey signed an opening the door for broader exemptions, the state had some of the nation’s strictest childhood vaccination policies. 

The loosening of those policies is occurring amid a deadly measles outbreak that has infected over  across 30 states and despite state legislators rejecting a bill in March which would have codified religious exemptions into state law. The conflict between the governor’s order and the legislature’s action has over how West Virginia officials should proceed and could ultimately lead to legal action between the two branches of government. 

In the meantime, the West Virginia Department of Health is granting religious and philosophical exemptions based on the governor’s order and shared those numbers in response to a Freedom of Information Act request by ����Ӱ��.

No requests for the newer category of exemptions has been denied, the department said. In contrast, 125 requests for medical exemptions to mandatory school vaccines have been rejected since 2015. Temporary medical exemptions have been granted to 288 West Virginia children in the past decade.

Richard Hughes, a George Washington University law professor and leading vaccine law expert, said the 331 religious and philosophical exemptions sought in just five months represent a “drastic, dramatic increase in the request for exemptions, and that’s going to potentially have public health consequences.”

He added the state appears to be approving them liberally and without real scrutiny.

“Clearly, when you open the door to these types of exemptions, people use them,” he said. “There has been evidence before that when only religious exemption is available, people request them without any really sincerely held belief. This just opens the floodgates.”

While the 331 students who have received exemptions represent a very small percentage of the approximately enrolled in public schools across the state, experts fear the number will continue to rapidly climb, especially at the start of the coming school year.

“You see how fast we approved those? Hundred percent approved … So if we keep allowing an executive order that goes against West Virginia code, it’s going to change the vaccination rate …” said Sissy Price, a registered nurse who serves as co-director of West Virginia Families for Immunization. “And it’s not a matter of if it’s going to happen, it’s a matter of when.”

Experts also emphasized the importance of knowing which regions or schools in West Virginia the exempted students come from to better understand the impact on herd immunity and to allow parents — especially those of immunocompromised students — to make informed decisions about where to send their kids to school.

Despite the governor’s insistence that the state collect that information, an official at the Health Department wrote in an email to ����Ӱ��, “Nobody in the Department of Health or the Bureau for Public [Health] tracks that.”

“There’s a failure of government there,” said Northe Saunders, executive director of the pro-vaccine . “There’s a failure of making sure that parents can make the best informed decision that they can if we don’t know what immunization rates are like at the school level.”

The governor’s office and the Department of Health did not respond to requests for comment.

So far, West Virginia has no reported measles cases. Two children, both of whom were unvaccinated, have died during the current outbreak, whose case numbers have already surpassed 2024’s total and mark the second-highest number of confirmed cases in a year since the disease was declared eradicated in the U.S. in 2000. Some 96% of reported infections have involved a person who was unvaccinated or whose status was unknown and 13% have resulted in hospitalization. 

In issuing his Jan. 14 executive order, Morrisey relied on an interpretation of the state’s 2023 Equal Protection for Religion Act.

He argued that the law as it stood “forces” some West Virginians “to choose between their religious belief and their children’s fundamental right to public education,” and directed the commissioner of the Bureau for Public Health and the state health officer to establish a process for parents to object. The executive order noted that a “written, signed objection” was sufficient.

Based on the legislature voting down the measure to codify the broader exemption category, state schools Superintendent Michele Blatt issued a memo earlier this month to county superintendents recommending that students not be allowed to attend school next year without required immunizations, regardless of requests for religious exemptions. 

“We are faced with the fact that state law has not been changed by the Legislature and there is no religious exemption provided for in West Virginia law,” Blatt wrote, according to reporting by

But, by the end of the day she rescinded the memo, she had done so “at the Governor’s request.” 

Morrisey then issued May 9 saying that despite the legislative hurdle, the executive order “still stands, and I have no intention of rescinding it.” He further clarified the process to receive an exemption: Each year, parents or guardians must send a signed letter with basic information including their child’s name, date of birth and mailing address. Notably, the letter does not need to include the reason for the requested exemption.

In the wake of this confusion, some school districts have begun seeking about how to respond. 

West Virginia is not an outlier in its quest to allow parents to opt their children out of the measles, mumps and rubella vaccine that is a requirement in all 50 states for children entering child care and schools. 

“It goes towards the general erosion of vaccine policy,” said Saunders. “We’ve seen these kinds of small, incremental changes that are eroding vaccine policy in states across the country. There are still school entry requirements in West Virginia — just like there are in every single state — but this is one other chink in the armor of strong vaccine policy driving strong immunization rates.”

Childhood vaccination since COVID, and there’s fear that decline will accelerate now that Robert F. Kennedy Jr., a well-known vaccine skeptic, is heading the U.S. Department of Health & Human Services. He initially in late February, and on May 14, at his in Congress since his confirmation, he waffled on the importance of vaccines.

When asked if he would vaccinate a child of his own against measles today “Probably for measles. What I would say is my opinions about vaccines are irrelevant.”

He continued, “I don’t want to make it seem like I’m being evasive, but I don’t think people should be taking medical advice from me.”

Last week, the Food and Drug Administration, which falls under HHS, released guidance for COVID vaccines, saying they may require additional studies before approving the shots for healthy Americans younger than 65.

Candice Lefeber, executive director of West Virginia’s chapter of the American Academy of Pediatrics, said this move played into one of her fears: “I think the administration is going to make it harder for vaccines to be available.”

“Not only are we not going to require it, but then access to vaccines would be compromised,” she continued. “It’s just really disheartening for science and for our country — and we’re in big trouble.”

The West Virginia House Monday rejected its version of a Senate bill that would have loosened school vaccine requirements and expanded exemptions, voting it down

The bill’s defeat came after the House twice amended the Senate’s version of the legislation, first to remove both the philosophical and religious exemptions approved by the Senate and then to and to allow private and parochial schools to set their own mandatory vaccine requirements.

“The pro-vaccine messaging won out,” Northe Saunders, executive director of the pro-vaccine , told ����Ӱ�� Monday.

West Virginia now has among the country’s strictest regulations governing the immunizations required for children entering child care and schools, allowing for medical exemptions only. It’s unclear what might come next.

While the House’s vote effectively killed the current legislation, over a dozen other vaccine-related bills have been introduced in the West Virginia legislature and the governor signed an executive order in January establishing the religious and philosophical exemptions that House members rejected.

Saunders said time may be running out for the other vaccine-related bills to move forward during this legislative session.

An amendment that would give West Virginia parents much greater leeway to exempt their children from mandated school vaccinations was deleted from a House bill at the last minute this week, but the prospect of far fewer students in the state getting immunized remains strong.

As written, the would still expand and loosen requirements for medical exemptions for students, making them “the broadest … in the country,” one advocate said. The religious and philosophical exemptions that were struck from the House version of the legislation could also be reintroduced and, while it doesn’t carry the same force of law, Gov. Patrick Morrisey’s January order establishing similarly far-reaching exemptions is also hanging in the balance.

Historically, West Virginia has had some of the nation’s strictest childhood vaccination policies and the current move to soften them is occurring against a deadly measles outbreak that has infected in 15 states and taken the life of one school-age child in Texas. 

“It’s hard to wrap your head around why we would do this right now — or anytime,” said Candice Lefeber, executive director of West Virginia’s chapter of the . “But at such heightened alertness with measles spreading in our country, it should be a wake-up call. And unfortunately, I don’t think that’s happening,”

West Virginia is not an outlier in its quest to allow parents to opt their children out of the measles, mumps and rubella vaccine that is a requirement in all 50 states for children entering child care and schools. 

On Wednesday, Idaho lawmakers passed a that would significantly broaden an existing law banning COVID vaccine mandates to include mandates on any “medical treatment.” If the governor signs it, the bill would apply to public and private schools as well, making Idaho the first state in the country to remove all mandatory school vaccination requirements.

Childhood vaccination since COVID, and there’s fear that decline will accelerate now that Robert F. Kennedy Jr., a well-known vaccine skeptic, is heading the U.S. Department of Health & Human Services. He initially in late February, and in a March 4 seemed to link the ongoing outbreak and child fatality to malnutrition and poor health while pointing to unproven treatments, such as cod oil.

“The best thing Americans can do is to keep themselves healthy,” Kennedy said in the interview. “It is very, very difficult for measles to kill a healthy, well-nourished person.”

Three months in, the number of measles cases has already surpassed 2024’s total and in the 15 states where it’s spread, 95% of infections have involved a person who was unvaccinated or whose status was unknown. Three of those states border West Virginia, although, so far, the Mountain State has no reported cases. 

‘We just want the policy left alone’

The latest House bill still has a more wide-ranging medical exemption that also protects health care providers who grant them “in good faith” from civil liability, except in cases of “gross negligence or willful misconduct.” 

It also includes no enforcement mechanism from a government oversight body nor is there guidance as to what qualifies someone for a medical exemption. 

Northe Saunders, executive director of the pro-vaccine , fears this might lead to bad actors writing “bogus” exemptions. Saunders’ group, which is based in Portland, Maine, opened a West Virginia chapter in February after local advocates asked for their help amid the exemptions push.

“We’re glad that the religious and philosophical exemptions were not part of the bill that came out of committee,” said Saunders, who believes the measles outbreak was a factor in their being cut, “but we expect [attempts to modify the bill] going forward.” 

Saunders said his organization is tracking an additional 20 vaccine-related bills in the West Virginia legislature. And, across 20 states, 47 bills have been introduced which would add or broaden vaccine exemptions.

Parents across the country are able to apply for exemptions if their child is unable to get vaccinated for medical reasons. Most states also have religious exemptions, and 20 have some form of leaving a varied landscape. 

West Virginia is currently one of only five states that don’t allow any exemptions, beyond medical ones. Last school year, they had the for four of the major mandated vaccines, significantly outperforming national averages. Almost all kindergarteners there — 98.3% — had received both doses of the measles, mumps and rubella vaccine. 

The state also had the lowest rate of exemption, with less than 0.1% of kindergarteners being exempt from one or more vaccines. And it was the only state that supported Donald Trump for president in November that did not see an average rise in official exemptions. 

That could change, depending on the fate of the pending legislation and the governor’s executive order.

“The current policy as is, is something that is highly favored among myself and my colleagues,” said Andrea Lauffer, an internal medicine doctor and pediatrician at WVU Medicine – Thomas Memorial Hospital in South Charleston. “We just want the policy left alone.”

Michael Ramey, president of the , noted the role the pandemic has played in the current vaccine skepticism. He said that while his organization does not hold a position on the safety or efficacy of vaccines, it stands in support of bills like the one in West Virginia.

“We welcome a move to give parents greater authority to make the decision that’s best for their individual child,” he said. 

The vast majority of Americans — 88% — believe the benefits of the childhood vaccine for measles, mumps and rubella outweighs the risks, compared with just 10% who say the risks outweigh the benefits, according to a 2023 Seventy percent of Americans say healthy children should have to be vaccinated to attend school, down from 82% in 2019. And the share of parents who think they should be able to decide against vaccination is up 12 percentage points from four years ago, to 28%.

This shift is being driven by Republicans, 57% of whom now support vaccination requirements — down from 79% in 2019.

‘The heat is on’

The debate over vaccine mandates in West Virginia is not new, but “this year, definitely, the heat is on, for sure, at a higher temperature,” said Sissy Price, a registered nurse who serves as co-director of .

Last year, former Gov. Jim Justice vetoed a bill which would have allowed private and parochial schools to set their own vaccination policies. Meanwhile, Morrisey signed his executive order creating religious and philosophical exemptions on his first full day in office.

The governor wrote that current mandatory vaccine laws force West Virginians who have objections “to choose between their religious belief and their children’s fundamental right to public education.” The order, he said, was based on his interpretation of the Equal Protection for Religion Act, signed by Justice in 2023. 

The pending legislation was meant to clarify and codify his order. Even if the bill’s final version does not include religious and philosophical exemptions, the governor’s executive order would still stand, said Richard Hughes, a George Washington University law professor and leading vaccine law expert. 

While the ability to set new laws lies only with the legislature, the governor does have the ability to interpret those laws, which is what his executive order does, Hughes said.

If the executive order is not in line with what the legislature passes, however, it would remain vulnerable to court challenges.

“The governor could be checked by the courts on this interpretation,” he said.

Introduced Feb. 13, would have allowed parents to simply provide a written statement to exempt their child from vaccines for religious or philosophical reasons and applied to public, private and parochial schools.

In addition to loosening the medical exemption process and protecting medical professionals from disciplinary actions, it would also eliminate the position of state immunization officer and no longer require schools to report a violation if an unvaccinated child without an exemption attempted to enroll.  

At a Feb. 21 committee meeting, both Democratic and Republican senators spoke out in opposition to the bill. Many cited the measles outbreak that began in West Texas in late January as core to their concerns.

GOP Sen. Mike Oliverio read aloud from a letter written by one of his constituents, a retired physician.

“Loosening these requirements will eventually lead to outbreaks of these diseases, including in our children, as the number of vaccinated individuals fall,” he read. “I urge you to vote against this bill for the sake of West Virginia’s children.”

A number of Republican lawmakers also spoke in favor of the bill, which ultimately passed by a 20-12 vote, with two senators absent, before going to the House. 

The House bill that came out of committee this week is now expected to move to the floor, where it will be debated and potentially amended again. If the final House bill that passes still differs from the initial Senate bill, senators will need to either accept the House’s version or head to a conference committee to reconcile the two before sending it on for Morrisey’s signature.