PORTLAND, Maine — Justices with the state’s highest court grappled Thursday with whether the state was justified in ordering vaccination for a child in its custody against a parent’s wishes.

The hearing comes just days after a parade of speakers packed a legislative committee hearing in Augusta to debate Maine’s vaccine requirements for children.

The Maine Department of Health and Human Services took temporary custody of a 1-year-old after the child allegedly was abused by the father, according to court documents, which kept the family members’ names confidential. The agency received a report in June 2014 from child welfare officials in Massachusetts, where the mother had moved to be closer to family, according to the documents. She later moved with the child to Presque Isle and then Portland.

A lower court determined the child was in jeopardy, finding the mother failed to recognize that her allegedly violent relationship with the father put the child at risk. The District Court ordered the state to approve vaccinations, deemed necessary by a pediatrician.

The mother opposes vaccination, based on her personal spiritual beliefs and a desire to avoid institutional medical care in favor of natural treatments, according to Erika Bristol, her Lewiston attorney. Bristol argued Thursday before the Maine Supreme Judicial Court that the lower court wrongly determined the child was at risk and interfered with the mother’s parental rights because of her beliefs.

While the courts can intervene to prevent a child from facing serious risk, vaccines are a recommended but not required preventive measure, she said.

Assistant Attorney General Meghan Szylvian, arguing on behalf of DHHS, disagreed, saying the child could be harmed by contracting a vaccine-preventable illness.

“The law doesn’t get to decide your views are right or wrong unless there’s abuse or neglect,” Bristol said.

Chief Justice Leigh Saufley questioned earlier decisions by the mother to decline antibiotics for the child at birth and an evaluation for a potential hearing problem. The mother had stated that “if a child dies, that just happens” and that its care was “up to the universe,” Saufley and Justice Donald Alexander noted.

Bristol said the mother’s choice to decline treatment resulted in no harm to the child, who was healthy when DHHS took custody. To get the child back, the mother must agree to the immunizations, she said.

While the District Court ordered the immunizations, it remained unclear whether the child has been fully vaccinated yet. Court documents indicate some immunizations were administered.

In Maine, parents may skip vaccines for their children for medical, religious or philosophical reasons. Most Maine parents vaccinate their children, but federal data show the percentage declining vaccines is on the rise. More than 750 kindergartners started public school in 2013 without receiving all of the required immunizations because their parents opted out, according to the U.S. Centers for Disease Control and Prevention.

Maine’s opt-out rate was the fourth-highest in the nation.

Bristol argued that the lower court ruled unfairly against the mother, given that Maine’s vaccine law allows parents to decline vaccinations. But Szylvian told the justices the law permits only “fit” parents to make that decision and cited the “monumental responsibility” the state assumes upon taking a child into custody.

Szylvian also disagreed with Bristol that the mother’s opposition to vaccines was the sole reason for the District Court’s finding that the child was in jeopardy.

Saufley questioned Szylvian about whether the courts should treat vaccination, which carries long-term or permanent effects, differently from ordering that a child receive antibiotics for an ear infection or treatment for an injured knee.

“Any action the department takes could be seen as acting into the future,” Szylvian said.

She later added that while some parents believe vaccines are harmful, many medical treatments carry harmful effects. Preventing the state from vaccinating children in its custody on that basis would hamstring DHHS in providing a variety of medical care, she said.

Overwhelming scientific consensus finds that vaccines are safe for the vast majority of people and effective at reducing or eliminating deadly diseases.

The justices issued no decision Thursday. There is no timeline under which they must rule.

Jackie Farwell

I'm the health editor for the Bangor Daily News, a Bangor native, a UMaine grad, and a weekend crossword warrior. I never get sick of writing about Maine people, geeking out over health care data, and...