How Well Do Religious Exemptions Apply to Mandates for COVID-19 Vaccines?

In the United States, religious exemptions to health-driven mandates enjoy, and should enjoy, protected status in medical ethics and healthcare law. Religious exemptions are defined as seriously professed exceptions to state or federal laws, which appeal to Title VII of the Civil Rights Act of 1964, allowing workers to request an exception to a job requirement, including a health-protective mandate, if it "conflicts with their sincerely held religious beliefs, practices, or observances". In medical ethics, such religious exceptions are usually justified on the basis of the principle of autonomy, where personally held convictions, reflected in scripture or established religious norms, are safeguarded on the basis of the first amendment, thereby constituting an important area in which societal good must yield to individual liberty. Acknowledging the longstanding category of "religious exemptions", and referencing some examples that adhere to its parameters in good faith (e.g., objections made by some institutions to HPV vaccines), I argue that, to date, no coherent basis for religious exemptions to COVID-19 vaccines has been offered through appeal to the principle of autonomy, or, in a healthcare context, to "medical freedom". Indeed, proponents of characterizing these exemptions as legitimate misconstrue autonomy and abuse the reputation of the religious traditions they invoke in defense of their endeavors to opt out. The upshot is not only an error in interpreting the principle of autonomy, whereby it is issued a "blank check", but also a dishonesty in itself whereby a contested political position becomes deliberately disguised as a protected religious value. "Sincerely held beliefs", I conclude, appear no longer to constitute the standard for religious accommodation in the era of COVID-19. Individual declaration, seemingly free of any reasonable constraint, does. This is a shift that has serious consequences for public health and, more broadly, the public good.