Three families in New York claimed that their right to free exercise of religion was violated when their unimmunized kids were barred from school because of the state’s vaccination practices. Their case was brought before the Federal District Court in Brooklyn. They lost.

According to New York state law, children must be vaccinated before attending school. There are exemptions: if immunization is detrimental to the child’s health or if the guardian holds “genuine and sincere religious beliefs which are contrary.” Supporting documentation is required, and in the latter case, the school can decide to reject the request.

However, in the event of an outbreak of a vaccine-preventable disease -- we’re talking diphtheria, polio, measles, mumps, rubella -- in a school, city officials may exclude the attendance of unimmunized students, regardless of whether they’re in the process of being vaccinated or if they’re exempt. It’s the responsibility of the school to maintain a list of susceptible students, who can return when the risk abates. This is called “social distancing,” and effective July 1st, new school attendance regulations will expand vaccine-preventable illnesses to include chickenpox, whooping cough, tetanus, Hib, pneumococcal disease, and hepatitis B.

So, that brings us back to Phillips v. City of New York. Earlier this month, Judge William F. Kuntz II cited a 109-year-old Supreme Court ruling that gives states broad power in public health matters when he ruled against the three families, the New York Times reports. In 1905, a Massachusetts man disobeyed an order to be vaccinated during a smallpox outbreak and was fined $5. Here’s an excerpt from the judge's ruling (which is a fascinating read):

Plaintiffs argue that the vaccination program at issue denies their children the constitutional right to free exercise of religion, but not only has the Supreme Court strongly suggested that religious objectors are not constitutionally exempt from vaccinations, Jacobson v. Commonw. of Mass., 197 U.S. 11, 35-39 (1905), courts in this Eastern District have resolutely found there is no such constitutional exemption.

Two of the families in the lawsuit (who have received religious exemptions) said the city’s policy amounted to a violation of their First Amendment right to religious freedom, among other claims. Their children had been kept from school, sometimes for a month at a time, when other students had, for instance, chickenpox.

The third plaintiff said the city denied her child a religious exemption, after her medical exemption was (apparently mistakenly submitted and hence) denied. Her daughter was then home-schooled and later accepted into a private school without being vaccinated. (While the policies cover both public and private schools, the latter have more autonomy with exclusions.)

In New York state, the average religious exemption rate rose over the last decade, the Times reports, from 0.23 percent to 0.45 percent. City schools granted 3,535 religious exemptions in the 2012-2013 school year. Among the 25 measles cases in the city between February and April this year, two of them were school-age children whose parents refused vaccinations. One of children was home-schooled, but had a sibling who was granted a religious exemption. When the child contracted measles, the city barred the sibling from school.