Supreme Court Associate Justice Stephen Breyer, along with Justice Amy Coney Barrett and Brett Kavanaugh, voted to deny a stop to Maine's vaccine mandate. Credit: Erin Scaff / The New York Times via AP

The U.S. Supreme Court on Friday refused to stop Gov. Janet Mills’ vaccine mandate for health care workers on the first day it was to be enforced. 

Maine’s mandate requires health care workers be vaccinated against COVID-19 by Oct. 29 or risk losing their jobs. There’s an exemption for those who can’t be vaccinated for medical reasons but not for religious objections, which was the basis for the legal challenge by the group Liberty Counsel. 

The organization said it was representing more than 2,000 health care workers across the state who object to the vaccine on religious grounds.

The refusal to stop the mandate marks the latest legal turn for Mills’ vaccine mandate for health care workers, which the governor announced in August. The mandate has faced legal challenges in both state and federal courts. Judges at all levels so far have upheld the rule.

Justices Amy Coney Barrett and Brett Kavanaugh joined Justice Stephen Breyer in the denial of Liberty Counsel’s request for an injunction halting the mandate. They agreed with the appellate court in Boston that the issues raised in the case needed to be fully briefed before an injunction should be issued.

Justices Neil Gorsuch, Samuel Alito and Clarence Thomas would have granted the injunction. 

“This case presents an important constitutional question, a serious error, and an irreparable injury,” Gorsuch wrote in the dissent. “Where many other States have adopted religious exemptions, Maine has charted a different course. There, healthcare workers who have served on the front line of a pandemic for the last 18 months are now being fired and their practices shuttered. All for adhering to their constitutionally protected religious beliefs. Their plight is worthy of our attention.”

Chief Justice John Roberts and Justices Sonia Sotomayor and Elena Kagan did not weigh in on the case.

The Liberty Counsel filed the lawsuit in August in Bangor’s U.S. District Court. The group announced late Friday that it would ask the nation’s high court to consider the merits of the case following oral arguments. It was unclear whether that could be scheduled before the end of the year.

Mill and Maine Attorney General Aaron Frey issued a joint statement late Friday praising the decision and repeating what they have said before — vaccinations are the best tool to protect the lives and livelihoods of Maine people.

“Health care workers perform a critical role in keeping Maine people healthy, and it is imperative that hospitals and other settings take every precaution to protect their workers and patients against this deadly virus, especially in view of the more infectious Delta variant,” Mills said. “Anyone who is placed in the care of these facilities has the right to expect —  as do their families —  that they will receive high-quality, safe care from fully vaccinated staff,” 

Frey, whose office must defend the vaccine mandate, said that the latest court decision shows again that the requirement is constitutional.

“Getting vaccinated against COVID-19 is the best way to prevent further burdens on Maine’s healthcare system, and the best way to protect ourselves, our neighbors, and our loved ones,” he said. 

The Supreme Court upheld an Oct. 15 ruling by the 1st U.S. Circuit Court of Appeals in Boston that agreed with a federal judge in Maine. 

“Stopping the spread of COVID-19 in Maine, and specifically stemming outbreaks in designated healthcare facilities to protect patients and healthcare workers, is a legitimate government interest,” U.S. District Judge Jon Levy concluded. “For several reasons, the mandate is rationally related to this interest.”

The judge wrote that the vaccine mandate will raise vaccination rates in health care facilities that have been susceptible to COVID-19 outbreaks, which have primarily been the result of employees bringing the virus into their workplaces with them. Vaccinations of health care workers will reduce the risk of such outbreaks, Levy said.

Maine eliminated religious and philosophical exemptions for all vaccinations for school children and health care workers in 2019, and the state has applied that law to the COVID-19 vaccine.

Ultimately, the constitutional questions concerning vaccine mandates, which are being challenged in courts in other states, will be decided by the nine justices on the Supreme Court. 

A Maine Superior Court judge came to a similar conclusion earlier this month. But plaintiffs in the case she ruled on did not argue as the federal case did that the mandate should include a religious exemption. Rather, it focused on the state’s rulemaking process.

Superior Court Justice Michaela Murphy last week also said that those attempting to stop the rule have not proven that they would ultimately prevail on the merits of the case — a requirement for issuing an injunction stopping the mandate. She also said the mandate and the way it was implemented did not violate Maine law or the U.S. Constitution.

That lawsuit was brought in early September in Kennebec County Superior Court by a coalition called the Alliance Against Health Care Mandates formed to oppose Maine’s vaccine requirement for health care workers. Maine Department of Health and Human Services Commissioner Jeanne Lambrew and Maine Center for Disease Control and Prevention Director Nirav Shah are defendants.

Murphy’s decision is expected to be appealed to the Maine Supreme Judicial Court.