In this case, two children under the age of five have been in the continuous care, custody, and supervision of the Division of Child Protection and Permanency due to the abuse and neglect of their parents. The trial court granted the Division's application to vaccinate the children with age-appropriate immunizations over the religious-based objections of the parents. The court granted the mother leave to appeal.
The children are not students. Therefore, the religious-based exemption to immunization of students afforded by N.J.S.A. 26:1A-9.1 and N.J.A.C. 8:57-4.4(a) does not apply. Rather, the matter is governed by the Child Placement Bill of Rights Act, N.J.S.A. 9:6B-1 to -6, and N.J.S.A. 9:6-8.86(b), which collectively require that children in placement receive adequate and appropriate medical care to maintain and advance their mental and physical well-being, and N.J.A.C. 3A:51-7.1(a)(2), which specifically requires the administration of all age-appropriate immunizations.
Parental rights are not absolute and must yield to the safety and well-being of the children. While parents do not lose all of their parental rights when their children are placed in the custody of the Division, they are situated differently than parents who retain legal and physical custody. Pursuant to the State's parens patriae responsibility to protect the welfare of children, the Division has a duty to provide appropriate medical care and treatment to children in its custody. This duty encompasses the authority to administer age-appropriate immunizations over the religious objections of the parents. The court perceives no meaningful distinction between the power to order prophylactic medical care in the form of vaccinations to prevent a child from contracting infectious diseases and medical treatment for diseases already contracted.