The US Court of Appeals for the Eighth Circuit ruled Friday that Missouri’s requirements for parents to opt out of their children being vaccinated to attend school do not violate their rights to religious freedom.

In Missouri, children must be properly vaccinated and submit their vaccination records before they can attend school. However, there are exemptions. For religious reasons, parents can opt out of vaccinating their children if they submit one specific form from the Missouri Department of Health and Senior Service.

The form includes a message from the Department of Health and Senior Services at the top, which strongly encourages parents to vaccinate their children and informs them that unvaccinated children will not be allowed to attend school in the “in the event an outbreak of a vaccine-preventable disease within a particular facility.” It also includes a checklist of the immunizations the child refuses for religious reasons.

The plaintiffs, who were parents of school children refusing to vaccinate their children on religious grounds, challenged the requirements. They claimed that the requirements violated their First and Fourteenth Amendment rights. They claimed they refused to sign the form because of the message printed at the top of the form. The district court dismissed their claims.

Plaintiffs argued that the form “compels their speech” and is therefore unconstitutional. The appeals court said that the form did not compel plaintiffs to affiliate with the immunization statement, because the form simply stated the government’s position. The form also did not preclude them from giving their religious objections in other forms- there was nothing stopping the parents from submitting additional statements. The form ultimately did not violate the plaintiffs’ rights to freedom of speech.

The court also found that the form did not abridge the free exercise of religion. The plaintiffs objected to the production of vaccines and the actual vaccination of their children, and the form itself did not make the parents complicit in either of those processes. The parents had the ultimate decision of whether to vaccinate their children. The form also did not target religious believers, because any parent requesting an exemption would have to file that form.

Because of this, the appeals court affirmed the dismissal of the claims.