A trial court properly issued an order requiring that the parties’ child be vaccinated by a pediatrician and for the parties to select a new, mutually agreeable pediatrician for the child, the Michigan Court of Appeals held in Matheson v Schmitt (Docket No. 347022).

The plaintiff-mother and the defendant-father were married in 2013. They child was born in 2015. A judgment of divorce was entered by the Oakland County Circuit Court in April 2016. The divorce judgment provided that the parties shared joint legal custody of the child and the plaintiff had primary physical custody. The judgment further provided that the defendant would not have overnight parenting time with the child until she reached the age of 13 months and that the defendant’s parenting time would gradually increase as she became older.

In February 2017, the defendant filed a motion seeking make-up parenting time and asked the trial court to order that the child be vaccinated because the plaintiff was refusing vaccinations. After “extensive” evidentiary hearings, the trial court ruled in December 2018 that it was in the child’s best interests to be vaccinated. According to the trial court, vaccination would protect the child from a host of potential serious diseases and the evidence did not establish that any vaccinations would be harmful to the child or that vaccination was otherwise against her best interests. In particular, the trial court pointed to a lack of evidence from an immunologist or other qualified physician that indicated the child was predisposed to injury or would likely incur an autoimmune disorder as a result of being vaccinated. The trial court further ordered that the parties had to select a new, agreed-upon pediatrician for the child and that the defendant’s parenting time should be expanded.

The plaintiff-mother appealed. She argued, among other things, that vaccination was not in the child’s best interests because vaccinations are medically contraindicated.

The Court of Appeals affirmed the trial court’s order mandating vaccination. However, it remanded the case for the limited purpose of allowing the trial court to confirm what vaccinations the pediatrician recommended for the child, before the course of vaccinations begin.

“[W]hat is at issue,” the Court of Appeals wrote, “is whether the administration of vaccinations is in the child’s best interests, taking into account her physical health. Even accepting as valid and accurate plaintiff’s contention that the child bears some predisposition to incurring an autoimmune disorder because of her family history, this attenuated risk, in and of itself, simply does not outweigh the significant benefits that would inure to the child by protecting her from the threat of serious and life-endangering diseases in the population.”

Judges Thomas C. Cameron, Mark J. Cavanagh and Douglas B. Shapiro joined the per curiam, unpublished opinion.

No ‘Persuasive Evidence’ Presented

Before addressing plaintiff’s anti-vaccination arguments, the Court of Appeals first noted the legal framework that the trial court had to follow when ruling on the issue of vaccinations.

“Although plaintiff alleges at the outset that the issue whether to vaccinate the child should have been left to her discretion alone, the parties’ judgment of divorce expressly provides that the parties share joint legal custody of the child,” the Court of Appeals wrote. “Accordingly, because the parties share joint legal custody of the child, the question whether to vaccinate the child implicates a significant medical decision. However, the parties could not agree on this issue so it was appropriate to seek judicial intervention.”

Here, the trial court properly adhered to a preponderance-of-the-evidence standard when determining whether vaccinations were in the child’s best interests, the Court of Appeals observed. “Further, the court properly determined that an evaluation of the child’s best interests required it to weigh the factors set forth in MCL 722.23. … In determining the child’s best interests, the trial court found that the factors set forth in MCL 722.23(b), (c) and (l) were particularly relevant. The court also considered the remaining factors in MCL 722.23 but found that they were not relevant to its decision concerning whether vaccinations were in the child’s best interests. The court concluded it was in the child’s best interests to be vaccinated ….”

The Court of Appeals then turned to the plaintiff’s argument that vaccinations were not in the child’s best interests because they are medically contraindicated. In this regard, the evidence “did not indicate that the child would likely suffer any harm from being vaccinated, or that the benefits of protecting her from disease were outweighed by any potential adverse effects.”

The Court of Appeals acknowledged that the plaintiff presented evidence that vaccines can have adverse effects. However, “the fact that vaccines can potentially cause very serious adverse effects is not in dispute, and the child’s family history of autoimmune disorders is also not a point of contention,” the appellate panel stated. “But the dispositive issues are not whether vaccines can potentially cause adverse effects, or whether the vaccine manufacturing industry and pharmaceutical companies are unduly influencing governmental regulatory agencies.”

Rather, the issue was whether the administration of vaccinations was in the child’s best interests, considering her physical health, the Court of Appeals explained. “[T]he threat of harm to the child by exposing her to vaccines that could potentially trigger an autoimmune disorder is speculative, and the record does not otherwise demonstrate that the child would be put at risk of harm by receiving vaccinations,” the appellate panel said.

“In the words of the trial court, plaintiff did not present persuasive evidence establishing that ‘[the child] will be harmed by any particular vaccination and/or that any particular vaccination is otherwise contrary to [the child’s] best interests,’” the Court of Appeals said. “Significantly, the trial court afforded plaintiff ample opportunity to secure the services of a qualified immunologist or other qualified physician to (1) review the results of the medical testing that was conducted on the child, (2) to perform additional testing, and (3) confirm that the child was in fact predisposed to injury or death if she were vaccinated. Plaintiff did not take advantage of these opportunities.”

Therefore, “because the record does not contain evidence establishing that (1) the child would in fact likely suffer harm from being vaccinated, and (2) that any alleged risk of harm outweighed the clear benefits to the child of being protected from life-threatening diseases, defendant met his burden of establishing, by a preponderance of the evidence, that vaccination was in the child’s best interests,” the Court of Appeals concluded.

Religious Beliefs

Next, the Court of Appeals addressed the plaintiff’s argument that the trial court erred by failing to consider her sincere religious objections to vaccinations.

“More specifically, plaintiff alleges that the trial court ‘was in no position to weigh the sincerity or judge the acceptability of [plaintiff’s] religious beliefs or reduce those beliefs as being [subordinate] to [defendant’s],’” the Court of Appeals wrote. “We disagree.”

Citing In re Deng, 314 Mich App 615 (2016), the Court of Appeals pointed out the Public Health Code (PHC), MCL 333.1101 et seq., includes a statutory scheme that governs the administration of vaccines in Michigan. “While MCL 333.9205, MCL 333.9208(1), and MCL 333.9211(1) place certain requirements on parents to vaccinate their children within certain age periods or by the time a child is enrolled in school, MCL 333.9215(2) also allows a parent to seek an exemption from the vaccine requirements on the basis of ‘religious convictions or other objection[s] to immunization.’ Accordingly, under the provisions of the PHC, plaintiff would be able to seek an exemption from vaccines for the child on the basis of her religious beliefs.”

However, while the defendant in this case shared joint legal custody of the child, he does not share the plaintiff’s alleged religious objections to vaccinations, the Court of Appeals observed. “In this context, under the CCA [Child Custody Act], because the parties are unable to agree on an important matter impacting the child’s welfare, it was appropriate for the trial court to decide the matter in the child’s best interests.”

According to the Court of Appeals, the plaintiff appeared to argue that, by ordering the child to be vaccinated, the trial court undermined her religious freedom. “This Court has recognized the importance of a party’s religious freedom, as well as the interplay between that religious freedom and the right to raise one’s child in the manner one sees fit. … However, while the statutory scheme of the PHC would allow plaintiff to exempt the child from the mandatory vaccination requirements for children on the basis of plaintiff’s religious beliefs, the PHC is not controlling here. The trial court was not considering this dispute under the provisions of the PHC but rather under the provisions of the CCA, which gave the court jurisdiction to address, consider, and decide matters related to the child’s legal custody and best interests where the parties with joint legal custody over the child were unable to agree.”

Contrary to the plaintiff’s assertion on appeal, “the record indicates that the trial court gave plaintiff great latitude in raising and explaining her religious objections to vaccines,” the Court of Appeals said. “Further, the trial court did not ignore plaintiff’s expressed religious beliefs in its evaluation of the child’s best interests.”

However, the trial court ultimately did not find that plaintiff’s testimony on the subject of her religious objections rendered this factor “more or less favorable to either party,” the Court of Appeals stated. “Additionally, the record does not support plaintiff’s contention that the trial court ‘weigh[ed] the sincerity or judge[d] the acceptability of [plaintiff’s] religious beliefs,’ or subordinated plaintiff’s beliefs to defendant’s. Instead, the record shows that the trial court gave serious consideration to such important matters as it weighed the child’s best interests, but ultimately determined that plaintiff’s religious objections to vaccines did not outweigh its determination that vaccinating the child was in her best interests.”

Accordingly, “the trial court did not err by determining that it was within the child’s best interests to be vaccinated,” the Court of Appeals ruled.

Remand

The Court of Appeals noted that, although it was affirming the trial court’s order requiring vaccination, nearly a year had passed since the trial court entered its written opinion and order in December 2018, requiring that the child be vaccinated as recommended by the State of Michigan. Therefore, “we remand this case to the trial court to allow it to confirm what vaccinations the child now requires at her age,” the Court of Appeals said.

“On remand, the trial court is directed to enter an order requiring defendant to produce a letter from the child’s current pediatrician, within 21 days of entry of this Court’s decision, addressing (1) any vaccinations the child has already received, (2) the dates any vaccinations were administered, and (3) the vaccinations that are recommended for the child as of the date of entry of this Court’s opinion,” the Court of Appeals wrote. “Once the trial court receives such documentation from the child’s pediatrician, within 7 days the court shall enter an order directing that the child be vaccinated in conformance with the pediatrician’s recommendations, and the trial court’s order should further provide that the course of vaccination must begin within 21 days of the trial court’s order.”

In December 2019, the Court of Appeals denied the plaintiff’s request for reconsideration. Then on February 6, 2020, the Court of Appeals issued the following order in the case:

“The Court orders that the motion to lift stay is GRANTED. In our November 21, 2019 opinion remanding this matter, exercising our authority of MCR 7.215(F)(2), the trial court was directed to immediately take steps to effectuate our ruling regarding vaccinations. The trial court having failed to comply with this direction, this Court now clarifies that our November 21, 2019 opinion is given immediate effect. MCR 7.215(F)(2). Within seven days of the date of this order, the trial court shall enter an order requiring defendant to produce a letter from the child's current pediatrician addressing (1) any vaccinations the child has already received, (2) the dates any vaccinations were administered, and (3) the vaccinations that are recommended for the child as of the date of this order. Within seven days of receiving the pediatrician’s letter, the trial court shall enter an order directing that the child be vaccinated in conformance with the pediatrician’s recommendations, and the trial court’s order should further provide that the course of vaccination must begin within 14 days of the trial court's order.

On March 6, 2020, the Michigan Supreme Court denied the plaintiff’s application for leave to appeal.