Friends,
In my past vaccine exemption work, I’ve seen mandatory TB tests come up in three different situations: For school children in Guam, healthcare workers, and immigrants. TB (tuberculosis) is an infectious disease affecting the lungs, though it can spread to other parts of the body. TB vaccines are used in other countries but not in the U.S. But TB test requirements pop up from time to time in the U.S. Since TB tests are not vaccines, vaccine exemption laws don’t help people avoid mandatory TB tests. However, there are ways to legally avoid them.
First, there are three different ways to test for TB:
1) Mantoux Tuberculin Skin Test (TST): Proteins derived from Mycobacterium tuberculosis bacteria are injected under the skin, and the injection site is checked two to three days later for a reaction that can indicate whether the person has been exposed to tuberculosis. If the test result is positive, additional tests are needed to determine whether the person has a latent or active infection.
2) Interferon Gamma Release Assay (IGRA): This is a blood test. A blood sample is laboratory-tested to determine if a person has been infected with TB. If the test result is positive, additional tests are needed to determine whether the person has a latent or active infection.
3) Chest X-Ray: Can show evidence of TB infection in the lungs and may be used initially or as a follow-up to a positive result from a TST or IGRA test.
The likelihood of someone having a medical contraindication to all TB tests seems exceedingly low, so the rest of this article addresses the rights of people with religious objections to TB tests. I’m not aware of any situation where there’s a legal right to refuse mandatory TB tests on personal or philosophical grounds.
First, I’ve never heard of a TB exemption law, though in theory such laws could be enacted. But when one has religious objections to TB tests, there may still be a legal right to refuse the tests on religious grounds. The objector will likely need to present a statement of their legally qualifying religious beliefs opposed to the test(s) to the person(s) issuing the mandate, and quite possibly a legal analysis showing their right to refuse despite no applicable exemption law.
Second, what matters legally is not whether one is opposed to one or all of the TB tests, but rather, that regardless of one’s position in that respect, whether their religious beliefs match that position. Some people are opposed to only the TST; others to all TB tests. If one were opposed to only the TST on the ground, say, that the injected proteins were “unclean” in the objector’s interpretation of the Old Testament use of that word, that person might have no religious objection to the IGRA or a chest x-ray, and so could offer to do an alternative test if initially required to get the TST. If one was physically well and interpreted the New Testament passage, “Only the sick need a physician” as prohibiting medical tests and treatments for well people, that might prevent them from submitting to any of the TB tests.
If one objects to only the TST, they could offer to do the blood test or chest x-ray instead, giving the mandating authority a way to get what they want while accommodating the objector’s religious beliefs. If one is opposed to all of the tests on religious grounds, one may have to rely solely on the legal right to refuse, and that may include having to persuade the mandating authority that there’s no serious health risk with their not being tested. You see, religious freedom is not an absolute right. Where health risks are sufficiently high, religious freedom can be restricted. If the mandating authority is sufficiently concerned about the risks of someone not being tested, they may be inclined to deny a request for a religious waiver.
Keep in mind that while having non-religious objections to TB tests doesn’t invalidate one’s religious objections, non-religious objections shouldn’t be mixed with religious objections when seeking a religious exemption or waiver (whether to vaccines or TB tests). Mixing the two, such as raising a concern about harm from the procedure (where one doesn’t have a recognized medical contraindication) could potentially give the appearance that the religious beliefs are a false cover for non-religious concerns, or that the religious objections are a secondary concern to what is primarily a non-religious objection. Either way, the religious exception could be lawfully denied.
The fundamental legal issue with religious exemptions is about what beliefs qualify, legally—what beliefs are protected (by law) religious beliefs. While we get to decide what we believe, we don’t get to decide what beliefs are “religious” for legal purposes (though we can decide to our heart’s content for our own private purposes). The law decides what beliefs are protected by law, and that turns out to be inconsistent with most people’s common-sense thinking. So, it’s important for objectors to find out what beliefs qualify legally, so they can present a legally sound position regarding their religious objections. It’s difficult to impossible to address this after an exemption request is rejected, to say, “oops—pretend I didn’t say that. Here’s what I meant to say…” This is one of those situations where you need to get it right the first time.
Regarding the three different situations where people have requested my help avoiding mandatory TB tests:
1) Employment (healthcare workers)
Title VII of the Federal Civil Rights Law—the same law that provides an out on religious grounds to vaccines required for employees—can be used to refuse employer-mandated TB tests, too. Title VII isn’t an exemption law, it’s a workplace anti-discrimination law addressing several categories: race, color, national origin, sex, and religion. As to religion, Title VII can potentially apply to any employer requirement that conflicts with an employee’s religious beliefs or practices, not just medical procedures. The information in my recent three employee vaccine exemption articles applies to mandatory TB tests, except where the information is specific to vaccines. For example, vaccines are given to a healthy person today to protect against hypothetical future disease exposure, whereas TB tests are checking for a present infection. So, a belief that vaccines interfere with God’s choice about future events may work for a vaccine religious exemption, but it would not apply to TB tests that look for a present infection. But a belief that injecting germ components is religiously “unclean” could apply to both vaccines and TB tests.
Employee vaccine exemption articles: Part I, Part II, Part III.
2) Grade School (Guam)
As a general rule, the U.S. Constitution applies to governments, not to private entities. Where a school mandates TB tests, which I’ve only seen once with a school in Guam (a U.S. territory), it was a public school. So, there was no issue about the parents’ right to request a religious exemption to the TB test requirement despite there being no TB test exemption law, as their religious beliefs and practices were protected by the “free exercise” clause of the First Amendment of the U.S. Constitution. Please note that we don’t get to decide how to apply the “free exercise” clause; it applies as determined by legal precedent, which comes from past court cases addressing similar or analogous matters.
Where there’s no explicit exemption law (and I know of no TB test exemption statutes or regulations anywhere), formulating a legal argument requires finding applicable legal precedent. For example, a U.S. Supreme Court case says parents may exercise their religious beliefs and practices with their children up to the point where doing so causes harm or a significant risk of harm. Arguably, a healthy child not getting a TB test poses no harm if the parent’s religious objection is only to the TST, as the other tests could adequately address the underlying health concerns. If a parent’s religious beliefs were opposed to all TB tests, the level of risk would depend on the statistical likelihood of a non-tested child having or developing TB and/or spreading the disease to others. The risk level could vary widely from situation to situation, of course, so would require evaluation on a case-by-case basis.
3) Immigration
I’ve successfully assisted 100’s of immigrants with vaccine religious waivers over the years but only recall one time when a client raised a concern about a TB test requirement. I found no federal USCIS (immigration service) regulations providing an exception to the TB test requirement, but since this is a federal government agency, Constitutional rights apply. So, the matter concerned whether the person objecting to the test had, and could articulate, legally qualifying religious beliefs opposed to the test(s); and whether the USCIS determines the risk to be sufficiently high to deny the requested exception.
The right to refuse mandatory health treatments and procedures on religious grounds is not absolute. Where doing so poses a sufficiently high health risk, health authorities can legally deny religious exception requests. In theory, balancing religious freedom with community health concerns enables doing what’s best for all concerned. Unfortunately, where infectious diseases are concerned, it’s not just about the right decide what we’re going to do with our own (or our children’s) bodies, because our behavior could affect the health and safety of others (assuming the widely accepted germ theory, which is contradicted by compelling evidence, has merit).
The problem is that our healthcare system has been co-opted by corrupt elite putting profit and control ahead of the safety and wellbeing of the rest of us. So, those balancing religious freedom and community welfare aren’t doing so in a truly scientific manner; they’re doing it in a way that maximizes pharmaceutical profits, often to the detriment of the general public. They use their power to push through policies that aren’t supported by real science and law to advance their private agendas. So, mandates that shouldn’t exist are imposed on us; some exemptions that should be allowed often aren’t allowed; some exemptions that should be granted get denied; and protests against all of this from the masses is conspicuously absent due to psychological manipulation that causes most people, including most brilliant medical doctors, to support these scientifically flawed health policies believing they are sound, despite abundant evidence to the contrary. Friends, the masses are not incompetent or lacking critical thinking skills; the manipulation is actually that powerful. It covertly controls victims’ perceptions, what looks logical to them. They truly believe they’re doing what’s best. And the same psychological tactics that hide the problem from the masses hides real solutions from us, which is why decades of ever-greater activism work have always been met by an accelerating pharma-control agenda. We do more, greater, better; they do faster. We’re clearly missing something. This is that something, and we’re missing it because it’s invisible; it leaves its victims experiencing the opposite of what’s actually happening.
Nevertheless, understanding our rights is the best starting place when we’re dealing with legal matters. Sometimes, at least, that gets the desired outcome. If you need an exemption, by all means get one—it could save your life! But understand that getting an exemption doesn’t awaken the masses, and it doesn’t stop the advancing agenda. To accomplish that, we must take additional steps to address the underlying corrupt power that can force pharma “wins” in any system—legislature, court, agency, etc.—regardless of any contrary science and law; and they assert this power whenever it really matters to their agenda. The project referred to periodically through this substack platform gives us a way to neutralize that power, so that all of our activism work can finally be freed up to get us the Big Win, to finally turn the pharma ship around once and for all. Stay tuned…
With gratitude,
Alan Phillips, J.D.
Vaccine Rights Legal Expert
Have a vaccine exemption question? Contact Alan at vaccinerights.com. Some questions may be addressed in future articles (with anonymity).
More Exemption Articles: vaccinerights.com/articles, vaccinerights.substack.com/archive
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Alan Phillips, J.D., is the nation’s leading vaccine rights legal expert, the only person who’s ever been a fulltime attorney with exemptions, who’s worked in all of the roughly 60 exemption contexts and sub-contexts with clients, attorneys, legislators, and activists nationally for over two decades. For exemption information and assistance, see vaccinerights.com.