As the state reports its first measles case in eight years, rising religious exemptions raise public health and legal scrutiny
When Nebraska confirmed its first case of measles in nearly a decade in May 2024, public health officials immediately expressed concern—not just about the virus, but about a broader vulnerability: a steady increase in the number of parents claiming religious exemptions from school vaccination requirements.
Religious exemptions are currently the only nonmedical opt-out permitted in Nebraska. These exemptions require only a notarized affidavit stating that vaccination conflicts with sincerely held religious beliefs. No explanation of the belief or affiliation with any religious organization is required. That lack of scrutiny has led legal scholars and public health experts to question whether these exemptions are being used as a stand-in for personal or philosophical objections, which Nebraska law does not formally recognize.
In Lancaster County, 4% of kindergartners claimed a religious exemption in the 2024–25 school year—up from 1.8% in 2020–21. That rise contributed to an MMR vaccination rate of just 89% in 2024–25, below the 95% threshold public health experts recommend to prevent outbreaks (https://nebraskapublicmedia.org/en/news/news-articles/as-nebraska-reports-first-measles-case-in-8-years-state-contends-with-rising-religious-vaccine-exemptions/).
Legal precedent suggests the state is within its rights to impose stricter standards. In Prince v. Massachusetts (1944), the U.S. Supreme Court upheld the authority of states to restrict religious expression when public health or safety is at stake. “The right to practice religion freely does not include liberty to expose the community…to communicable disease,” the Court wrote. Yet Nebraska’s current law avoids conflict with this ruling by allowing any parent to claim an exemption without requiring substantiation.
This makes the state an outlier. Other jurisdictions, such as New York and Maine, have eliminated religious exemptions altogether or enacted policies requiring detailed documentation or education about vaccine-preventable diseases. Nebraska’s minimal approach, critics argue, creates a legal loophole that enables widespread abuse.
The core concern is pretext: when religious liberty is invoked not as a sincere faith-based objection, but as a workaround for personal or political opposition to vaccines. That undermines the legal purpose of religious protections, potentially exposing truly religious claimants to greater scrutiny in future litigation.
Public health implications are long-term. As vaccination rates decline, herd immunity weakens. Outbreaks of measles—one of the most contagious viruses—can rapidly spread in under-immunized communities. Infants too young to be vaccinated, as well as individuals with medical conditions that preclude immunization, face the highest risks. The World Health Organization warns that even a small drop in immunization rates can have outsized effects on transmission in communities where diseases like measles were once considered eliminated.
For now, Nebraska lawmakers have not indicated plans to change the state’s exemption laws. The Department of Health and Human Services continues to monitor immunization data and support educational outreach. If the exemption trend continues and more cases arise, renewed legislative or legal challenges could follow.