A defense of public health, or an attack on religious freedom? New York legislators passed a law late yesterday ending the religious exemption on vaccination requirements, leaving in place only an exemption for medical necessity. Andrew Cuomo wasted no time signing the bill, which took effect immediately — but not without angry protests over the infringement on religious rights:

“We are facing an unprecedented public health crisis,” said Sen. Brad Hoylman, D-Manhattan and the sponsor of the legislation in the Senate. “The atrocious peddlers of junk science and fraudulent medicine who we know as anti-vaxxers have spent years sowing unwarranted doubt and fear, but it is time for legislators to confront them head on.”

Hundreds of parents of unvaccinated children gathered at New York’s Capitol before the vote to protest what several called an assault on religious freedom.

“People came to this country to get away from exactly this kind of stuff,” said Stan Yung, a Long Island attorney who has three children.

Yung, who is Russian Orthodox, said he has religious views and health concerns that will prevent him from vaccinating his three young children. His family, he said, may consider leaving the state if the bill is signed into law.

This wasn’t a slam dunk in the state legislature. The bill only passed by ten votes in the state senate, 36-26, and the gap wasn’t much wider in the assembly, 77-53. The controversy over religious freedom turned out to be a bigger hurdle than some might have thought, especially in deep-blue New York. Expect more political backlash as the law goes into effect over the next 30 days, as parents will face new demands to submit vaccination records.

Part of the problem is that the religious exemption had no real controls on it. Many people used it in connection to legitimate religious doctrine, but as one person notes in the PIX 11 news report, many others used it as a means for their personal opposition to vaccines regardless of religious issues. The combination of the two left a lot of children without immunity and susceptible to exposure through travel or immigration, from a disease that the CDC declared eliminated in the US less than twenty years ago.

Regardless of what Yung says, people don’t come to the US just to get away from required vaccinations. Schools have required vaccinations for more than a century, with the Supreme Court approving the authority for such requirements in a 1905 case. Plenty of people have emigrated to the US since that time, and almost all of them get vaccinated at some point. An argument might be made, in fact, that the generally excellent health of the US population might be a bigger draw than some largely mythical ability to avoid vaccinations.

Perhaps if a solid test for religious exemptions could be developed that locks out the anti-vaxx manipulations of such loopholes, then the state might be able to make such a thing work. The epidemics of measles in New York and other states make it pretty clear, however, that these policies present a public-health danger, especially when it becomes faddish to exploit that loophole. Parents are required to send their children to schools, usually public schools, where unvaccinated children could put their own children in danger, which means that the schools have a responsibility to minimize that danger as much as possible. Vaccinations have been proven effective and reliable in mitigating — and until recently, eliminating — that danger.

The free expression of religious doctrine should be a high priority in American life, and too often is encroached by the nanny state. That’s why we passed the Religious Freedom Restoration Act (RFRA) at the federal level and in many states, and required strict scrutiny on laws and regulation that cross that First Amendment line. In this case, though, serious diseases threaten public health when required participation in education leaves children vulnerable, which crosses into a clear state interest that would easily survive strict scrutiny. New York made the right decision in this case.