MA Supreme Court: DCF Can’t Vaccinate Without Permission

In a new and closely watched ruling, the Massachusetts Supreme Judicial Court (SJC) made one thing very clear: the Department of Children and Families (DCF) cannot vaccinate a child in its temporary custody over the religious objections of the parents.

But the decision is not as sweeping as it might sound. It hinges on the specific circumstances of the case and on constitutional limits—not on vaccines themselves. This wasn’t about whether vaccines are safe or effective. It was about who gets to make the decision when a child is in state custody temporarily, and the answer, in this case, was that the parents still do.

The case, Care and Protection of Eve, began when a newborn was taken into temporary DCF custody after concerns about domestic violence.

The department moved quickly to begin routine vaccinations according to CDC guidelines. The parents, practicing Rastafarians, objected on religious grounds and asked the court to stop the vaccinations. The lower court sided with DCF, saying the child’s best interests came first. But the SJC reversed that ruling, saying the department had failed to meet the constitutional threshold required to override the parents’ religious rights.

At the core of the decision is the concept of residual parental rights. Even though the state had temporary custody of the child, the court emphasized that the parents’ constitutional rights had not been terminated. They still had a right to direct their child’s religious upbringing, and that right includes decisions about medical care that touch on their religious beliefs. The fact that custody was temporary—not permanent—mattered greatly. The parents hadn’t been found unfit by clear and convincing evidence, and their rights hadn’t been severed. Until that happens, the court said, they retain a constitutionally protected role in such decisions.

The legal test applied under the Massachusetts Constitution is specific and demanding. When the state burdens someone’s religious beliefs, it must show that the policy serves a compelling interest and that denying an exemption would substantially hinder that interest. It’s not enough for the state to simply say, “This is good for the child.” That’s the best-interests standard, and the court rejected it as too open-ended when constitutional rights are in play.

In this case, the court found that the parents sincerely held their religious beliefs and that vaccinating the child over those objections would substantially burden those beliefs. Although the state does have a compelling interest in protecting children’s health, the court said the department failed to show that exempting this specific child would meaningfully undermine that goal. Two facts stood out. First, Massachusetts already allows religious exemptions to school vaccination requirements for children whose parents retain custody. Second, DCF had not vaccinated this child’s three older siblings, who were also in its care. That inconsistency cut sharply against the department’s claim that exempting this child would cause real harm.

The court also pushed back on the idea that being in foster care increased the child’s exposure risk so much that vaccination became essential. The child was in a kinship placement, not a group setting, and the department offered no solid evidence that her risk profile was dramatically different from her siblings, who remained unvaccinated. It wasn’t enough to wave at general public health goals. The law requires specifics, and here, the department didn’t provide them.

This ruling doesn’t mean DCF can never vaccinate a child over parental objections. It means that when custody is only temporary, and when the parents raise sincere religious objections, the state has to make a strong and particularized case. It has to show that granting a religious exemption would truly compromise its goals. Broad assertions and inconsistent practices won’t cut it.

So the takeaway isn’t that DCF’s hands are tied. It’s that constitutional rights—especially those involving religion and parental authority—don’t disappear just because the state steps in for a time. The SJC reaffirmed that even when the state acts to protect children, it has to do so within constitutional boundaries. In this case, DCF crossed the line. The court told them, in effect, you have authority over routine medical care, but when it comes to overriding religious convictions, you need more than general arguments and medical affidavits. You need a compelling reason tied directly to the child’s situation, and a clear showing that no exemption can be tolerated. DCF didn’t have that here. So they lost.

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