For decades, West Virginia has had a “halo” of protection around it, thanks to a compulsory-vaccine law. But now, there’s a case that could topple that law — and have major implications for the rest of the country.
By Katherine Eban, Rolling Stone, October 8, 2026
ON A CRISP DRY DAY in Beckley, West Virginia, last September, 35-year-old litigator Chris Smith wore his lucky purple tie to court. With a wry smile, round face, and piercing blue eyes behind metal-rimmed glasses, Smith enjoyed a hard fight. But as he slid into his seat for defense counsel in a courtroom crowded with lawyers, luck did not seem to be on his side.
Smith’s client, the West Virginia Board of Education, faced an uphill battle to save the state’s compulsory-vaccination law, which for 89 years had helped thwart the spread of infectious diseases. The state’s ambitious Republican governor, Patrick Morrisey, was aiming to allow parents a religious exemption to school vaccinations. He had powerful outside allies in his fight, including Health Secretary Robert F. Kennedy Jr. and one of his close confidants, a lawyer now seated to Smith’s right, Aaron Siri.
Siri, 48, bald and compact with lively dark eyes, looked ready to spar. While most of the lawyers in the courtroom were native West Virginians, Siri is a New York City plaintiff lawyer who’d relocated to Arizona and had spent more than a decade aiming to dismantle any law or regulation that mandated vaccination. As he’d put it in a 2022 tweet: “Mandates are the tool of bullies, criminals, and dictators.” His firm, Siri & Glimstad, has litigated state by state to loosen vaccine laws.
Schoolchildren in West Virginia can only skip required vaccines for medical reasons. In a state with roughly 235,000 kids in school, the health department issued only 203 full medical exemptions from 2015 to 2025. Siri was representing Miranda Guzman, a mother battling the education board so she could exempt her child from school vaccinations.
Siri now confronted Dr. Jacob Kilgore, the Raleigh County Board of Education’s expert witness, sitting placidly on the witness stand. [….]
Siri ticked through diseases, asking Kilgore: In a less-densely populated state like West Virginia, would religious exemptions really impact the level of immunity to measles?
“I think it depends on what you mean by ‘densely populated,’” Kilgore responded.
[….]
In an era of partisan rage over public-health mandates and growing antipathy to scientific expertise, vaccination in America is on a knife’s edge.
For almost a century, the public has largely agreed on a social compact: We should vaccinate our kids not only to prevent individual harm, but to also shield the more vulnerable among us, whether the immune-compromised or infants too young to be vaccinated.
The public school system has stood at the center of that compact, with the requirement that children be vaccinated to attend, all but guaranteeing that our communities reach herd immunity, the level of protection that makes it harder for frightening infectious diseases — whether polio or measles — to take hold. A 1905 U.S. Supreme Court ruling, Jacobson v. Massachusetts, affirmed the right of states to require vaccination.
But fighting in the name of religious, medical, and personal freedom, an array of lawyers, state and federal officials, and President Donald Trump himself are seeking to break that compact. And though their progress has been slowed by federal courts, painstaking local resistance, and the sheer complication of dismantling existing vaccine policy, a change is clearly afoot.
Since Kennedy became the nation’s health secretary in February 2025, vaccination rates for kindergartners have dropped more than two percent, parental requests for religious or philosophical exemptions to vaccinations for school entry have climbed to four percent, and infectious diseases once vanquished have ticked up. Measles — declared eliminated in the U.S. in 2000 — has surged to more than 3,600 cases this year alone, more than a twelvefold increase from 2024. A widespread outbreak in Pennsylvania this year led recently to four deaths, including two infants, according to state officials. (HHS spokesperson Emily Hilliard says “attributing the measles resurgence to President Trump or Secretary Kennedy fundamentally misrepresents when and why” it began — “pandemic-era disruptions” to routine vaccination started “years before they took office.” She says HHS remains committed to an “effective public-health response while respecting informed choice, parental rights, and religious liberty.”)
None of this is by accident. While Kennedy has sown parental doubt from his federal bully pulpit, it’s his legal confidant Siri, an expert in the circuitry of vaccine policy, with his hands on the motherboard, despite having no formal government role. Internal emails obtained by Rolling Stone show Kennedy offering to take departmental action to “be helpful” with certain private legal cases of the type Siri’s firm has pursued, and Siri advising Kennedy on departmental actions he can take to weaken liability protections for manufacturers without congressional approval. Siri says in an email to Rolling Stone, “I do not provide the secretary with legal or regulatory advice.”
Says a former HHS official, “What gets Aaron Siri up in the morning is to try and figure out every possible, conceivable tool to make it harder to vaccinate people in America.”
In the hydra-headed attack on vaccinations playing out across the country, only four states besides West Virginia — Connecticut, California, Maine, and New York — do not allow religious or philosophical exemptions. In August, Trump issued an executive order directing the U.S. attorney general to take legal action against them.
West Virginia is the only state among the five that has never permitted any exemption other than for medical reasons. Its compulsory-vaccination law has stood since 1937, an outgrowth of activism linked to coal-miner health and safety. “It’s hard to prevent the spread of pertussis in a coal mine,” says Dr. Joshua Hess, a pediatric hematologist-oncologist at Cabell Huntington Hospital.
Still, Siri had good reason to believe he could topple West Virginia’s vaccine law. In 2023, he prevailed in Mississippi, winning a lawsuit that allowed families to cite religious reasons to opt out of school-entry vaccinations. Since then, Mississippi’s vaccination rates have dropped by more than two percent, enough to allow a return of some infectious diseases. Last year, a baby there died of whooping cough for the first time in 13 years.
But in West Virginia, what began as a seemingly winnable campaign evolved into a complex legal showdown, with a number of intertwined court cases pitting West Virginia’s governor against the Department of Education, legislators within the Republican supermajority against one another, and locals against outsiders. The fight has even divided families, with one pediatrician testifying as a plaintiff to save the law, while his sister, a far-right state legislator, works to bring it down.
[….]
If the U.S. Supreme Court takes a case on vaccinations for school entry, the decision could drastically impact public health. It could be “potentially as earthshaking as the reversal of Roe [v. Wade],” says Manhattan Borough President Brad Hoylman-Sigal, who in 2019 as a state senator helped tighten New York’s vaccination law to remove religious exemptions, after a widespread measles outbreak began in several under-vaccinated Orthodox Jewish communities.
Siri told me this summer, “The only position my firm takes on vaccines is that everybody should be free to get as many vaccines as they want, but at the same token, everybody should be free to be able to decline a vaccine.”
In West Virginia, though, Siri’s opponents are fighting for a long-held value in their state, where getting a shot comes as second nature if it means protecting neighbors, even those you don’t know. West Virginia is the kind of place, as Kilgore later puts it, where “y’all means all.
[….]
Almost every year, some faction within the legislature has taken aim at the state’s vaccination requirements, only to meet with defeat. But on Jan. 14, 2025, the newly elected governor, Morrisey, a former pharmaceutical lobbyist who had aligned himself firmly with Trump and Kennedy’s Make America Healthy Again (MAHA) movement, issued an executive order on his second day in office. He directed the state health department to allow religious exemptions. In doing so, he leaned on a West Virginia law passed in 2023, the Equal Protection for Religion act, to claim that families could circumvent vaccine requirements if they didn’t align with their religious beliefs.
[….]
Morrisey’s move signaled a new kind of threat. “We’d never heard of executive orders in the state, except to lower the flag half-staff or give state employees a Christmas Eve ball,” says retired lawyer Robin Godfrey.
[….]
Godfrey formed the pro-vaccine volunteer group Stand for Kids, which now has coordinators in 44 of West Virginia’s 55 counties. By February, a handful of parents formed West Virginia Families for Immunizations, with backing from the national group American Families for Vaccines, which receives some funding from vaccine manufacturers.
With Republicans holding a supermajority in the West Virginia Legislature, Senate Bill 460 — which would have inscribed Morrisey’s executive order into law — seemed like a foregone conclusion.
A month after Morrisey’s executive order, the Senate Health and Human Resources Committee held a hearing. While three local pediatricians got about five minutes each, Siri was brought in virtually for nearly an hour. “West Virginia sits as an outlier in not respecting people’s individual and civil rights to be able to affirm their religious beliefs,” Siri testified.
[….]
The bill cleared the Senate and went to the House of Delegates, seemingly on a fast track to pass. But activists deluged legislators with calls, emails, and visits that flipped votes. Last March, the bill was defeated 56-42. “That’s the power of the advocate voice in West Virginia,” says Jessie Ice, co-director of West Virginia Families for Immunizations.
But the fight wasn’t over.
[….]
In the wake of the opioid epidemic, there are counties where close to half of the children are no longer being raised by their biological parents. Many of those children don’t even see a doctor until they’re five and must get vaccinations. The law has a transformative effect, says Takubo: “It gets these kids in front of a doctor for the first time.”
[….]
In the wake of Morrisey’s January 2025 executive order, the West Virginia Department of Health began to issue religious exemptions, the number of requests climbing to more than 570 within nine months. But on June 11, the Board of Education voted 9-0 to enforce West Virginia’s law as written and refused to allow the exemptions.
Within two weeks, Siri’s firm brought a lawsuit against the Board of Education on behalf of Miranda Guzman, a widow and neonatal ICU nurse, and one of the many West Virginians who had been granted a religious exemption for her child by the health department, only to find it blocked by the education board. Citing ongoing litigation, Siri declined to make Guzman available for an interview. But the complaint describes her longstanding Christian faith and “profound religious objections.” It states, “When Plaintiff is under conviction from the Holy Spirit, she is careful to obey, knowing that to do otherwise will entail eternal consequences.”
[….]
On Sept. 10, 2025, Dr. James Robert Neuenschwander took the witness stand in Froble’s courtroom, his manner confident, silver hair swept off his forehead.
Dr. Neu, as he was known, an integrative-medicine doctor from Michigan who sits on the board of the anti-vaccine group ICAN, was Siri’s first expert witness, and he’d submitted a report concluding that “a handful of religious exemptions” would present “no material risk” for vaccinated students.
Neu confidently posited that unvaccinated children would be likely to feel sicker, therefore be more likely to stay home when sick and, as a result, be less likely to spread disease. By contrast, vaccinated kids might pose the real threat, Neu testified, claiming that because they may remain asymptomatic, and because some vaccines do not block transmission, they could spread a disease like pertussis to unvaccinated students.
Siri then went further, asking if there are “any benefits” to children becoming infected.
“Yes. There’s some evidence,” Neu said, claiming that a study from Japan showed that getting measles and mumps reduced death from heart disease. Citing additional studies, he posited that high fevers from infectious diseases, particularly measles, could induce the remission of various cancers. “There does appear to be some benefit to actually having the disease itself,” he said, triggering scoffing in the courtroom.
Three infectious-disease experts say that Neu’s claims distort the truth: that infected children can spread disease long before they have symptoms, and that the risks of being infected far exceed any purported benefit. “In the 18th century, if people were sick, you quarantined,” says Dr. Yvonne Maldonado, the Taube Professor of Global Health and Infectious Diseases at Stanford University School of Medicine. “We don’t need to do that anymore because we have 17 diseases that we have essentially controlled” through vaccination.
When it came time to cross-examine Neu, Smith’s co-counsel, Benjamin Bailey, a former federal prosecutor and a founding partner of Bailey & Glasser, asked about his qualifications. Neu acknowledged he had failed to complete his surgical residency, was not board-certified in pediatrics, epidemiology, virology, or immunology, had no formal training in vaccines, and had never practiced in West Virginia. In 2004, he’d been hit with a $400,000 judgment after being accused of wrongfully prescribing medication that had caused a patient’s death. “I chose not to fight it,” he said, and settled it through a bankruptcy proceeding.
Then Bailey explained that the California Board of Medicine had rejected Neu’s expert testimony as not credible. He read aloud from the board’s 2021 judgment: “The court says, and I quote, ‘He does not believe any children should be vaccinated.’”
[….]
Siri says in an email, “Dr. Neu was chosen as an expert witness because he has the moral and ethical fortitude to state what the evidence actually shows regarding vaccines, even in the face of what mainstream journalists will write about him, rather than parroting mantras about these products.”
[….]
A Conveniently-Timed Letter
On Sept. 11, 2025, the second day of the Beckley trial, Siri took to the podium and tried to torpedo Smith’s expert witness, Dr. Catherine Slemp, a public-health expert who had served multiple roles in West Virginia government, including as health commissioner. From the witness box, she regarded Siri warily.
“Doctor, what is the federal Vaccine[s] for Children Program?” he began. The program helps states cover the costs of purchasing vaccines, a lifeline to immunize poor children.
Once Slemp described it, Siri then brandished a document that he had not yet entered into evidence. “Are you familiar with this letter?” he asked. The letter had been sent three weeks earlier by the director of HHS’ Office for Civil Rights to West Virginia’s health departments, and leveled a threat. It directed the state to allow a religious exemption for school vaccinations or risk losing its $1.3 billion in federal funding from the Vaccines for Children program.
Siri asked Slemp whether the prospect of losing that funding would lead her to change her testimony. The exchange troubled Slemp. Siri was “so definitive about what the letter meant,” she wondered, was he acting “as attorney in this case or as an adviser to HHS, either directly or indirectly?”
It was a reasonable conjecture, given the close, almost decade-long association between Kennedy and Siri, one that had helped catapult him from an unknown sole practitioner to a key tactician behind the U.S. vaccination schedule’s deconstruction.
To knowledgeable observers, the conveniently-timed letter appeared to be the result of coordination between HHS and Siri — which Siri denies. Says former HHS general counsel Bagenstos, it is “extraordinary and irregular” to have “the federal government telling the state how to interpret its own laws” or pay the price.
‘Inside the Castle Walls’
On Nov. 5, 2024, 10 months before the Guzman trial began in West Virginia, at an election-night watch party at a Palm Beach, Florida, hotel, Siri laid out his vision for Kennedy’s tenure as health secretary, according to a person present, describing how lifting legal protections for vaccine makers could set up a cascade of consequences that might force them from the marketplace.
Siri was “ready to burn the place to the ground,” as the person puts it. Siri denies that he has “ever spoken toward any goal of forcing vaccine makers out of the marketplace.”
As Kennedy prepared to become health secretary, Siri played a central if unofficial role helping to run the transition while working out of the Palm Beach home of Dr. Mehmet Oz, who would become the administrator of the U.S. Centers for Medicare and Medicaid Services. Siri tapped nominees for key staff posts, and grilled them about their positions on vaccines. Siri and his legal partner Elizabeth Brehm also screened potential members for the federal Advisory Committee on Immunization Practices (ACIP), which is supposed to be independent of HHS.
In an affidavit as part of an ongoing lawsuit against Kennedy by the American Academy of Pediatrics, Dr. Diana Zuckerman, president of the National Center for Health Research, stated that Siri’s law partner vetted her for a role on the ACIP committee, asking whether she would be comfortable saying that vaccine decisions should be made solely between parents and a doctor, without the intervention of an expert committee. After she disagreed, she did not hear further from Siri’s firm.
Health Secretary Kennedy served as co-counsel with Siri in 2018.
In December 2024, The New York Times reported that two years earlier, Siri had filed a citizen’s petition with the FDA to withdraw a critical polio vaccine from the market, and that Kennedy had privately expressed interest in his serving as the department’s general counsel. The blowback led Siri to go to ground for months. But he never went far.
Inside Health & Human Services, Siri has no formal role, but at times has functioned as a shadow senior adviser, say five current and former HHS officials and advisers familiar with the dynamic. Kennedy has consulted him by speakerphone during departmental meetings. He cites Siri “all the time,” says a former HHS official, so regularly sharing his legal advice that department lawyers joke “Wonder where that came from?”
An HHS official says that Kennedy was advised as a matter of “optics” to maintain “distance and separation” from Siri, advice that has gone unheeded.
Additionally, Siri — who sues HHS with regularity — has gotten access to the agency’s top echelons. Last October, Siri and his law partner were able to schedule a video call with the agency’s most senior lawyers, according to a meeting record obtained by Rolling Stone. Says a former HHS official, “Bobby has turned the department over to Siri” seemingly to support their overlapping endeavors.
[….]
‘The Lawyer Version of Setting Something on Fire’
On Oct. 8, 2025, the third day of trial, Dr. Joshua Hess took the witness stand, to testify not as an expert but as a dad. His immune-compromised daughter, a high school senior, suffers from congenital anemia and is exceptionally vulnerable to bacterial infections after having her spleen removed.
Hess and another parent with a medically fragile son had sued the West Virginia health department in May 2025, demanding it stop granting religious exemptions. Their case, brought by the West Virginia ACLU and Mountain State Justice, a legal advocacy organization, had been combined with Guzman’s.
Shortly after Hess filed his lawsuit, a far-right member of the House of Delegates denounced it in an editorial for a West Virginia news site, claiming that the ACLU and the Board of Education were “fighting tooth and nail to crush a parent’s right to decide what is best for their child.”
Hess’ critic was his sister, Kathie Hess Crouse, first elected in 2022 on a platform of medical freedom, homeschooling, and Second Amendment rights. She had attended the Jan. 6, 2021, Stop the Steal rally at the U.S. Capitol, though denied she’d stormed the building. She did not respond to numerous interview requests.
On the day Hess testified, Froble made several key decisions that left some of the lawyers “agog,” says the ACLU’s Sparks.
He granted a motion from Siri’s team to certify all the families who’d sought religious exemptions as a class of plaintiffs, chose to limit the lawyers’ fact-finding process of discovery, and said he would consider issuing a statewide injunction against the Board of Education, even though it was murky as to whether he had that authority.
Says an attorney with knowledge of the case, it was “the lawyer version of just setting something on fire.” (A court spokesperson said the code of judicial conduct precluded Froble from commenting on the case.) Then, in late-November 2025, Froble issued a sweeping ruling against the education board that halted its efforts to block the religious exemptions issued by the health department.
The Supreme Court of Appeals of West Virginia paused the ruling based on a motion from Smith and other lawyers, and considered an appeal. But not before the Siri & Glimstad team filed its own response, denouncing the concerns of the Board of Education’s lawyers as “Chicken Little” in fear of the sky falling. “They called us Chicken Little,” Smith says. “We have a fairly collegial bar. That is kind of unhinged.”
‘Tired of These Tourists’
For months, Smith kept a nervous eye on West Virginia’s Supreme Court of Appeals, awaiting a verdict that would either shred or save the state vaccination law.
But on April 8, a different decision dropped. The U.S. Court of Appeals for the Fourth Circuit published its ruling in one of the other related court cases pitting West Virginia parents seeking religious exemptions against a county education board. The Fourth Circuit eviscerated the arguments of the Siri & Glimstad team and upheld the education board’s right to require vaccination, even in an online education program. Celebratory text messages flew among Smith and his colleagues. “It’s a loss for the Siri & Glimstad team, which brings great joy to my heart,” Smith says.
While the Fourth Circuit decision offered a glimmer of hope in the Guzman case, it was a different case entirely, brought by Siri in New York state, that loomed even larger for Smith.
In 2023, Siri filed a lawsuit against the New York State Department of Health on behalf of several Amish schools that had been fined for not requiring vaccination. A district court dismissed the case, and the Second Circuit Court of Appeals upheld the decision.
Legal experts believe the U.S. Supreme Court could end up taking the case. The prospect leaves Smith “scared to death,” he says. “Whatever we do down here in West Virginia ultimately may not matter if the justices write some opinion saying that the First Amendment protects your right to go to public school without a vaccination.” Meanwhile, he continues to fight his corner as the waiting phase of the Guzman case stretches on: “I am getting tired of these tourists coming down and telling us what our laws should and shouldn’t be.”
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To try to better understand what motivates Siri, I exchange dozens of emails and several video calls with him before he agrees to an interview. On June 29, we sit down at the JW Marriott in Washington, D.C.
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While Siri insists his critique of vaccines is built on sound science and a forensic review of clinical-trial data, news breaks just weeks earlier that three studies Siri’s relied on to argue that vaccinated children face a greater risk of health problems than their unvaccinated peers have been “removed, retracted, or placed under investigation by the journals that published them,” The Guardian reports.
In response, Siri tells the newspaper the scrutiny is a “targeted assassination” and insists “the claim vaccines are ‘safe and effective’ is not supported by available evidence.”
[….]
Nonetheless, Kennedy is now HHS health secretary, and Siri is making his case on some of the nation’s biggest stages. But from where he sits, success remains elusive: No vaccines have been removed from the childhood vaccination schedule, though six of 17 have been moved to an optional category called “shared decision-making,” in which each family decides with their doctors. Even that shift has been frozen by a federal judge. “They should have just made all vaccines shared decision-making and left it at that,” Siri says.
As to the outcome in West Virginia, Siri expresses confidence that even if he loses, there remain plenty of paths — “through the legislature, different lawsuits, different approaches” — to a win. (As of press time, there is still no decision from the Supreme Court of Appeals of West Virginia.)
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