Elizabeth Clark and her family live in the Archdiocese of Washington, D.C.
Last year, her daughter attended an archdiocesan Catholic school, where she had an approved medical exemption for a childhood vaccination that she had not received.
But this year, when she reapplied for the exemption, it was denied.
Initially, Clark said, her daughter received her childhood vaccines according to the recommended CDC schedule.
But then, Clark told The Pillar, her daughter developed severe eczema that doctors could not explain. She also began reacting to almost every new food her parents introduced.
“She was having anaphylactic reactions and full body severe eczema that required steroids,” Clark said.
“And so I just thought, I wonder if this has something to do with maybe she's not tolerating so many vaccines well,” she said.
When it came time for Clark’s daughter to attend kindergarten, she had received all of the recommended vaccines except for one varicella — chicken pox — shot.
Clark said the insert for the varicella vaccine acknowledged a risk of eczema and other allergic-type responses.
But the vaccine insert only recognizes a few specific cases in which the shot would be contraindicated: pregnancy, febrile illness, untreated tuberculosis, immunodeficiency in the patient or family, or a history of severe allergic reaction to the vaccine or one of its components.
Clark’s daughter did not fall into any of these categories, since her reactions, although severe, had been to food rather than a previous dose of the vaccine itself.
Still, her daughter’s physician agreed that it made sense to skip the remaining vaccine, Clark said, given her daughter’s history of severe allergies and eczema.
Clark said she knew she would need to seek an exemption in order for her daughter to be at school.
Her daughter’s physician wrote a note, and the family applied for a medical exemption for the missing vaccine, which was approved by the local Catholic school.
This year, she knew she would need to reapply for the exemption, and she did.
But this time, it was denied.
That meant her daughter would be unable to attend the school without the chicken pox vaccine. Clark was worried the vaccine would bring the skin problems back. She said her doctor agreed. She felt stuck.
When she asked the archdiocese what had changed, Clark said the school superintendent’s office told her they did not have to give her an explanation.
The Archdiocese of Washington did not respond to questions from The Pillar about its vaccine policy, which says that if a “child has a valid medical contraindication to being immunized, and such contraindication is documented by a physician, an exemption [to ordinary vaccine requirements] may be permitted for the length of time certified necessary by the child’s physician.”
The policy does not seem to indicate how the exemption requests are to be evaluated — the issue that Clark says is unfair to her family.
Clark said she spent “the most stressful couple series of months” she had ever experienced trying to advocate for her daughter after the exemption request was denied.
But ultimately, she was unsuccessful at obtaining the exemption, and decided to pull her daughter out of school before the school year started.
The Clarks are now homeschooling – something Clark had never planned on doing. They’re not sure what the future will look like for the education of their children, an uncertainty that has been difficult for the family, she said.
Meanwhile, the Archdiocese of Washington is not alone.
As cases of measles rise in Texas, the Archdiocese of San Antonio has noted a declining vaccination rate in some schools, and indicated that its vaccine policies will exceed the standards set by public school districts.
“Catholic schools do not accept students who have received a parental choice or religious exemption from the immunizations required by Texas state law. Conscientious objections or waivers, which may be permissible for attendance in public schools, do not qualify as an exemption in Catholic schools in Texas,” Archbishop Gustavo García-Siller told Texas reporters this month.
In West Virginia, Bishop Mark Brennan told reporters that as his state’s legislature considers allowing private schools to set their own vaccine standards, the Diocese of Wheeling-Charleston month pointed to “not going to change our practice. We will be requiring the normal set of immunizations for children in our schools.”
“It really is for the good of the children and the staffs, but also the Catholic way is to contribute to the common good. Vaccinations have a more than two centuries track record of really helping to improve public health,” Brennan said this month.
Still, Clark’s case points to rising challenges for both schools and families amid growing vaccine hesitancy in the United States, especially when it conflicts with vaccine requirements at schools, both public and private.
Childhood vaccination rates have been falling for years. The decline was exacerbated during the Covid pandemic, as trust in public health officials waned significantly.
The CDC reported that during the 2023-2024 school year, kindergarten vaccination rates dropped for all reported vaccines from the prior year. Some 280,000 kindergartners do not have documented vaccination against measles, the CDC said, an increase of about 100,000 since before 2020.
Overall, vaccination rates remain over 90% in the United States, although public health officials have warned that some pockets of the country may be vulnerable to outbreaks of deadly diseases due to low vaccination rates, and in Texas, an outbreak of measles has reached more than 300 cases, more than the total number of U.S. cases in 2024.
But a growing number of parents are skipping vaccines. Their reasons are varied. Some are concerned that potential side effects from the vaccines could be worse than the diseases they protect against. Others worry that vaccines could have a detrimental effect on a healthy child’s natural immune system.
And data has found various links between Christian faith and vaccination rates.
According to 2024 research, Catholics in Poland “exhibited a lower Covid-19 vaccination intention” than atheists, and a 2022 analysis from 90 countries “showed that Christianity is negatively related to Covid-19 vaccination rates.”
Even before the Covid pandemic, researchers found lower rates of vaccination among people who identified as religious, with some studies finding a greater skepticism toward scientific research among religious people — while others suggested concern about the use of tissue derived from the bodies of aborted babies could be a factor for religious people.
On the other hand, 2022 data from Pew found that Catholics in the U.S. were more likely to be vaccinated than Protestants and religious unaffiliated adults, and 2021 research found that Catholics who attend Mass regularly were slightly more likely than infrequent attendees to be vaccinated against Covid-19.
Still, as vaccine skepticism rises, some parents have questioned whether vaccines are truly safe and effective — they argue, for example, that the FDA licensing process lacks sufficient long-term studies to determine with certainty that vaccines do not cause chronic health conditions.
Some Americans have also expressed the belief that vaccines cause autism, although public health officials have for years argued that there is no science to support this claim, with the CDC website saying the “studies continue to show that vaccines are not associated with ASD.”
As with many things in the U.S., the issue has become tinged with politics. The recent confirmation of noted vaccine critic Robert F. Kennedy Jr. as new head of the Department of Health and Human Services is likely to augment vaccine hesitancy.
For her part, Clark said she doesn’t consider herself to be “anti-vax.” But she said her daughter’s experience has led her to question the number of vaccines on the CDC schedule, and to wonder whether they might be contributing to the chronic disease epidemic in the United States.
Clark said she is not convinced that the safety studies conducted on vaccines are sufficient in gauging potential long-term effects, such as the development of chronic diseases.
“To my knowledge, none have been studied for safety over six months. So do we know the long-term effects?” she asked. “Are we shifting acute disease to chronic disease?”
Ultimately, she said, she sees the issue as a matter of parents’ rights.
“The way I came to this was just that I wanted to be the person that was able to make the best medical decisions for my child. That is how I see it,” she said.
“Of course, I don't have a 100% causal relationship between what happened, but I think instead of telling mothers that their motherly intuition is completely off, maybe we should start being a little bit curious about, why did her eczema and allergies go away? And maybe it wasn't the vaccines, but I could tell something wasn't adding up. I just think it's a shame that we are not taking the [parents’]… thoughts on this more seriously.”
The CDC recommends children receive vaccinations against 16 different diseases, and being up-to-date on vaccines is a general requirement to attend school; however, each state individually handles that requirement, and sets its own policy on exemptions.
All 50 states allow medical exemptions for children who have medical conditions that prevent them from receiving a vaccine — for example, if they have certain immune conditions or are allergic to a component of the vaccine, children are exempted by state policy.
The vast majority – about 45 states – also allow for religious exemptions. About a third of U.S. states further allow for exemptions based on personal belief.
The CDC says that vaccine exemptions increased in 40 states and Washington, D.C., last year.
Each state’s policies on vaccine exemptions apply to public schools within that state. But Catholic schools are not governed by the state policies on the issue, leaving each diocese responsible to set policies for local Catholic schools.
In some parts of the country, dioceses adopt the same policy which governs state public schools.
In other cases, the diocesan policy and the state policy differ. But a growing number of parents — including Clark — say that’s problematic, and that Catholic schools should use the same standards as their public counterparts.
Clark noted that her daughter had attended public school for pre-K, and the public school had allowed her to have a religious exemption.
“The religious exemption process was very simple, and nobody gave me a hard time at all. All I had to do was go in and sign a paper,” she said.
She added that the Presbyterian school down the road would also have allowed an exemption.
“Everybody around us will accept it,” she said.
But the Archdiocese of Washington, D.C. does not permit any religious exemptions, making their policy stricter than that of the state and public schools, she said.
“They say they don't accept any religious exemptions whatsoever. And that’s the case in multiple dioceses across the United States… They say they accept medical [exemptions], but as I've seen, it's very difficult -- you basically have to almost die to get it.”
Even if Vatican directives allow for the use of vaccines, Clark said she believes her family should qualify for an exemption, because she thinks that Catholic schools should honor the wishes of parents whose conscience compels them, for whatever reason, to decline vaccines.
Philip Cerroni, an ethicist at the National Catholic Bioethics Center, said he does not believe it is accurate to say that the Catholic Church takes a specific doctrinal or moral position on vaccine exemptions per se.
But Cerroni told The Pillar that there are principles in Catholic moral teaching which can shed light on the conflicts that arise, and the questions they bring with them.
To consider those questions, Cerroni said, it is important to recognize that the Catholic Church approaches the issue from a different framework than that of the U.S. legal system.
For example, the distinction between a religious and philosophical exemption is a legal issue, but not necessarily a significant distinction from a Catholic perspective.
Furthermore, he argued, the Church does not view the issue as a question of competing rights, but rather of responsibilities.
“There’s a strong tradition in Catholicism that people must not be required to do something they consider to be sinful in order to participate in an organization. And this springs, in part, from people's responsibility to use their reasoned judgment to follow the moral law…our moral responsibility to follow God's law,” Cerroni said.
At the same time, he said, the Church also has a strong tradition that an organization has the responsibility — and therefore, the authority — to make rules that, in its reasoned judgement, serve the common good within its own area of operation.
That authority requires the leaders of the organization making prudential judgments about various issues, including the role of vaccines in promoting the public good by protecting the health of the vulnerable from transmittable diseases.
Cerroni pointed to a document on vaccines from the Archdiocese of Philadelphia’s secretariat on education, which states, “Should the determination be made that the common good and justice are best served by making immunizations compulsory in order to enroll children, then the right to do so exists.”
“Although individuals have these rights of conscience that should be promoted as much as possible in carrying through with their reasoned judgments, higher level social organizations also have a responsibility to make rules to promote the common good in the way that they deem prudent,” he said.
These seemingly conflicting obligations to follow the moral law are at the root of the question of vaccine exemptions, and the conflict unfolding in schools.
For example, the Church has spoken clearly and repeatedly about this conflict in the case of objections to vaccines based on their connection to abortion.
Some childhood vaccines are manufactured utilizing fetal cell lines derived from the tissue of aborted babies, leading some Catholics to object to their use, on the grounds that doing so would be cooperating with the evil of abortion.
The Vatican has weighed in on the issue several times in the past 20 years, affirming that accepting such vaccines is a form of remote material cooperation in evil, acceptable under a Catholic bioethics framework where there is a proportionate reason — for example, the prevention of a serious disease.
At the same time, Cerroni said, “the Church has long affirmed that people are allowed to have a stricter moral standard than what is universally obligatory, and that these conscientious decisions should be respected.”
In other words, the Church says it is acceptable to use vaccines connected to aborted fetal tissue — and can serve the common good — but also says that if individuals have moral objections to receiving those vaccines, they must not be compelled to do so.
“The Church has, from its earliest days, affirmed that individuals must not be forced to do something that they believe causes them to sin,” Cerroni stressed.
But what about other objections to vaccines — for example that they are unnecessary for a healthy individual, or that they may not be as safe and effective as public health authorities claim?
In those cases, the objecting individuals may not necessarily believe that receiving these vaccines is sinful. Should they still, from a Catholic perspective, be given an exemption?
Cerroni said the Church has not been as explicit on those cases as it has been with the case of objections based on abortion-derived cell lines.
And, he said, “there is an important difference between, on the one hand, requiring someone to do something he believes is sinful, and on the other hand, requiring someone to do something that he doesn't think is necessary, or that he doesn't believe someone else has the authority to demand of him.”
Evaluating these latter cases requires balancing the individual obligation to follow his conscience with the organization’s obligation to enact policies it deems to be ordered to the common good.
One could make an argument that unhealthy choices are immoral, and so people should not be forced to make choices that they believe are unhealthy, Cerroni said. But that raises questions of moral consistency and coherency.
“There is a lot of discussion over artificial foods, artificial dyes, junk food, and their effect on chronic disease and other conditions. So if somebody says, ‘Well, I don't want to take this vaccine because of all of these effects that may be there,’ but they don't also take that kind of scrutiny to other things, that can be a problem for moral coherency…this isn't actually that you object to types of things that can have these adverse health effects, because this is the only place in which you draw that line.”
“Your decisions need to have their basis in a rational moral system and not just [be] based on caprice or opinion,” Cerroni said.
“On the other hand, there are very many people who are very careful about what they eat, they don't do any dyes, they're very careful about the cleaning products they use, about the soaps they use, and they are very much more consistent in avoiding things whenever possible that can have these adverse effects,” he continued.
Such people would have a stronger case in arguing in favor of exemption on moral grounds, he said.
Another important consideration, Cerroni said, is the principle of solidarity, a key tenet of Catholic social teaching, which recognizes a responsibility for the well-being of other people.
The principle of solidarity rejects the “every man for himself” mentality which might hold that because an individual has a strong immune system and takes care of their own health, they have no responsibility to those in a more vulnerable situation – for example, cancer patients or premature babies who have weak immune systems.
The question of safety and effectiveness is a significant one, Cerroni acknowledged. He pointed to the Ethical and Religious Directives for Catholic Health Care Services a guide released by the U.S. bishops to offer ethical standards in health care.
The ERD guidelines state that: “The truth that life is a precious gift from God has profound implications for the question of stewardship over human life. We are not the owners of our lives and, hence, do not have absolute power over life. We have a duty to preserve our life and to use it for the glory of God.”
If preserving one’s life and health is a basic requirement of the moral law, it can be problematic to require a person to do something that they believe forces them to violate this duty, he said.
In many cases, Cerroni said, parents objecting to vaccine policies seem to rely on their own evaluation of data, or those of outside experts, while school policies tend to cite public health authorities.
Of course, a person can rely on experts and sources of information besides official or mainstream ones, he noted. But the Church generally defers to public health authorities, Cerroni said.
“When it comes to questions of medical fact, the Church has generally said that these fall under the authority of the relevant health professionals rather than individuals, especially if the latter aren't experts in the field who are able to evaluate conflicting data,” he explained.
“This isn't to say that public agencies can't be wrong and that these schools can't be wrong in their information, but it’s just more difficult to claim unequivocally that one can make a moral objection to vaccination on these grounds.”
Ultimately, he said, Catholic school systems have to make a prudential judgment about vaccine policies, as they do about a host of other issues.
Those decisions must account for numerous factors –- public health is not the only factor in the common good, and should not be the only consideration for an organization in its policy decisions, Cerroni noted.
“Having access to education, especially for faithful, conscientious Catholics is very much in the common good. So there are also a lot of considerations there,” he said.
He acknowledged that parents may arrive at a different conclusion in their appraisal of the common good, and they must then come to a decision about what to do by weighing the benefits and burdens of their particular situation.
From a Catholic moral perspective, it is not clear that either party is in the wrong when such conflicts arise.
For its part, the National Catholic Education Association declined comments to The Pillar about the factors Catholic schools consider when setting their own policies on the subject.
The U.S. bishops’ conference stressed that vaccine policies are set at the diocesan level.
Still, some Catholics who object to vaccines say they want to find a way to convince diocesan officials to offer broad exemptions to school vaccine requirements.
The group Catholics for Exemptions was created last year to do just that.
Its founder, Maria Kemp, is a mother of four who helped to spearhead a group of families which successfully convinced the Diocese of Nashville to change its vaccine exemption policy last year.
Kemp and her husband had initially been vaccinating their children according to the recommended schedule.
But, she says, they became deeply disillusioned after she was fired for not receiving a Covid vaccine while pregnant with her third child.
As they started looking into studies on vaccine safety and efficacy more broadly, they found themselves becoming more and more doubtful. Eventually, they decided to stop vaccinating their kids altogether.
Kemp still wanted her children to attend Catholic schools. Her children are the third generation in her family to attend their local Catholic school in the Diocese of Nashville.
The state of Tennessee, where Kemp lives, allows for both medical and religious exemptions from required childhood vaccines. But when she looked into exemptions at the Catholic school that her oldest child attended, she discovered that the Diocese of Nashville did not allow religious exemptions.
The diocese had previously accepted religious exemptions, but in 2018 had introduced a new policy under which those exemptions were no longer accepted.
Kemp began reaching out to other parents, at multiple schools in the diocese, to see if there were other people facing the same dilemma.
“Honestly, it was quite easy. There are a lot of parents in the shadows just wanting to see change, but are very intimidated and very fearful of what it may mean for their children or for their families as they operate in their Catholic communities,” she said.
Kemp rallied a group of about 80 families to contact the diocese, which was in the process of selecting a new superintendent.
The interim superintendent was open to hearing their concerns, as was the superintendent who eventually took over as a full-time hire, she said.
The diocese held a listening session, and in March 2024, announced that it would change its policy to once again allow religious exemptions, in alignment with the protocol followed by the state.
The diocese did not respond to questions from The Pillar about its vaccine policy.
Kemp said was relieved. She also realized there were other families who could learn from her experience. She had been connected, via word-of-mouth, with other parents in Florida and Georgia who were similarly advocating for a policy change in their dioceses. Kemp said a Facebook group for those parents has grown to more than 500 members.
Members have a variety of objections to vaccines – religious, medical, and philosophical. But they agree in their conviction that vaccination should be a matter of parental choice, with the option of opting out, if one’s conscience compels one to do so.
Last fall, the group sent a letter with more than 300 signatures to the USCCB’s Committee on Religious Liberty.
“Our request, as Catholic parents, is that the policies denying our children access to parochial schools across this nation be seriously examined by your committee. We strongly urge you to work to ensure that all children, regardless of immunization status, be admitted to Catholic schools, as this poses no serious harm to the common good,” the letter said.
“There is no authoritative Church teaching universally obliging Catholics to receive any vaccine. As such, a person should not be discriminated against, and a baptized Catholic should not be refused access to Catholic schools on the basis of his or her vaccination status,” the letter said.
The letter cited a 2020 note released by the Congregation for the Doctrine of the Faith amid the Covid-19 pandemic, which states that “vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”
It also cited a statement from the USCCB’s Secretariat of Pro-Life Activities - originally released in 2007 and updated in 2015 - which says that “in an area where public schools are granting a conscience exemption, based on the view of public health authorities that doing so does not pose a serious risk to the population, Catholic institutions should be willing to do so as well.”
Asked about the letter, a USCCB spokesperson told The Pillar that the statement from the Secretariat of Pro-Life Activities “was based on the guidance from the Pontifical Academy for Life, and intended to be a helpful resource to the bishops in making decisions in their own dioceses.”
However, “it would be up to the local bishop to make the decision that he feels is best for his diocese, taking local circumstances and laws into consideration,” the spokesperson said.
Cerroni agreed that the document is a guideline for consideration, but said that the matter is ultimately one of prudential judgement.
“In the same way that an individual is allowed to have a higher personal conscientious standard than what's universally required, the same holds for a diocese or an institution - they can have a higher standard than is required by law.”
With regard to the CDF’s 2020 statement that vaccines should be voluntary, Cerroni said that from a Catholic perspective, there is a difference between an absolute mandate requiring everyone to receive a vaccine and a requirement to receive a vaccine specifically to participate in certain activities — such as school or the military.
Meanwhile, advocates like Kemp and Clark are not the only parents with views on the issue. The Pillar also spoke with parents who expressed concern that their Catholic schools would not, or were not, upholding diocesan policy — with some noting schools who seem to “look the other way” on diocesan mandates, and potentially putting their children in danger. But parents with those concerns told The Pillar they were hesitant to go on the record, because of the politicization of the issue, or the prospect of retribution from administrators or other parents if they appeared to be complaining about their parish schools.
As for Clark, she still hopes that her daughter will be able to attend a Catholic school.
“Especially as she's getting older, I want her to be able to go to a middle school, high school. And yeah, I mean, I went through Catholic school from pre-K to 12, so it's been really hard to think that she'll miss out on all that,” Clark reflected.
The family is now considering whether they should move in the next few years to a diocese with broader vaccine exemptions, which they had never previously considered.
“This has changed our entire life. I trust God that it'll be for the better,” she said. “However, I don't think every family that decides that one or more vaccines they don't want for their child, I don't think they should have to go through this.”
Editors’ note: This report was updated after publication to include additional data about vaccine rates.
