K.R. is a high school senior who is six months away from graduation, and up to date on all her vaccinations except for one. Her high school has now suspended her for failure to abide by state public health law requiring all vaccinations in order to attend school. The vaccine in question is the meningitis booster —K.R. received the initial dose in July 2019 when she was 11. A second "booster" dose is medically required at her current age. She is now 17 years old and will turn 18 two months after graduation, interestingly, the age at which she will no longer be legally mandated for the vaccination.

K.R. now sues her school district and principal to be readmitted so that she can graduate with all her classmates on time —approximately five months from now.

This case presents a cornucopia of issues, but can be narrowed down to 3 dispositive issues based upon the unique set of facts. This is just the latest in a string of cases filed in both state and federal Court challenging vaccine requirements by petitioner's counsel and others, oftentimes utilizing the same physician, a local Doctor of Osteopathy, and others.

Neither the law nor the facts are in dispute. New York Public Health Law (PHL) 2164 requires school districts to exclude students who fail to provide an acceptable certificate of immunization against a laundry list of communicable and easily transmissible diseases which are considered to be particularly harmful, and potentially fatal, especially to youngsters and adolescents. The list includes polio, mumps, measles, diptheria, pertussis, tetanus, hepatitis, and meningitis, among others. The statute permits a temporary exemption to the automatic ban in cases where a physician certifies that such immunization may be "detrimental to a child's [*2]health."

10 NYCRR 66-1.1 [c] is a regulatory statute that further clarifies that the physician's exemption certificate must contain "sufficient information to identify a medical contraindication to a specific immunization and specifying the length of time the immunization is medically contraindicated . . . .the principal or person in charge of the school may require additional information supporting the exemption."

In September 2025, Dr. Joseph Riccione (a doctor of osteopathy) signed an exemption certificate for petitioner, citing a "personal history of vaccine injury after [the first of two required meningitis immunizations]. Unstable chronic leg pain and mottling . . . .significant family history of altered immunocompetence . . . all within 7 days of vaccine. Exemption ends [in one year]" (NYCEF # 3). According to the school nurse, medical records indicate that the first time K.R complained of any symptom of leg pain was in April 2022, three years after the first dose of the meningitis vaccine (NYCEF #40) .

Three weeks later in October 2025, the school principal sent a letter to petitioner denying the exemption, relying on a letter from the New York State Department of Health and the School District's own Medical Director, indicating that "unstable leg pain or family history of altered immunocompetence are not listed contraindications or precautions to [the meningitis booster at issue]." Furthermore, wrote the principal, the statute permits an exemption only if the vaccine is "detrimental to the child's health." The purported information as to why the immunization is contraindicated, concluded the letter, does not satisfy the criteria in the Public Health Law or the regulations of the Health Commissioner for exemption to immunizations, and is not based upon current accepted medical practice.

Rather than take the ultimate final administrative step of appealing to the state Commissioner of Education (See NY Education Law 310), petitioner here filed an Article 78 petition in state Supreme Court. Respondents contend that petitioner has not satisfied her legal prerequisite of exhausting her administrative remedies.

It is well settled that a litigant who seeks to challenge the determination of an administrative agency must exhaust all possibilities of obtaining relief through administrative channels before appealing to the courts (Matter of Schiavone/Shea/Frontier-Kemper v. NY City of Env. Protection et al., 274 AD2d 586 [2d Dept. 2000]). However, there are specific exceptions where resort to the administrative remedy (a) would be futile, or (b) cause irreparable harm to petitioner (Id., See also Doe v. Oceanside Union Free School District, 25-cv-06214 [EDNY 2025]; Doe v. Ithaca City School District et al. [NY Supreme Court Index No. EF2025-1078]; Lehigh Portland Cement Co. v. NY State Department of Environmental Conservation, 87 NY2d 136 [1995]). The school district contends [*3]that Petitioner should have taken the final administrative step by appealing to the Education Commissioner. Petitioner contends that time is of the essence because graduation is less than 6 months away, and the Commissioner's decisions can take months (See www.counsel.nysed.gov/Decisions/ dcommissionersdecisions), thus that route would lead to irreparable harm. Moreover, contends petitioner, petitioner's review of Commissioner decisions from 1991 to the present, a span covering almost 35 years, reveals only one instance out of hundreds or thousands where the Commissioner overturned a School District's denial of exemption. Additionally, counsel requested an emergency stay from the Commissioner, which was denied (NYSCEF #1 at para. 11). Those actions, argues petitioner, are the very essence of futility.

Applying the law of exhaustion of remedies to the facts at bar, it is evident that the administrative process has played out the best it could, and with time ticking for petitioner in her final year of high school, any race to "beat the clock" of the state governmental bureaucracy would be futile. Administrative decision-making is by definition exhaustive, methodical and detailed, and not generally known for efficiency or expediency. Accordingly, it appears that petitioner's administrative applications, coupled with the environmental realities of the governmental bureaucracy, fit into the qualified exceptions described in Schiavone (supra), and Lehigh Portland Cement (supra), as futile and irreparable. Thus the Court finds that petitioner has exhausted her administrative remedies, therefore this Court has jurisdiction.

It is well established that a preliminary injunction is only warranted upon the satisfaction of three criteria: (1) Where it appears that immediate and irreparable injury, loss or damage will result unless the defendant is restrained; (2) a likelihood of ultimate success on the merits; and (3) a balance of the equities (CPLR 6301, 6311; see CPLR 7805; Accord Golden v. Steam Heat Inc. et al. 216 AD2d 440 [2d Dept 1995][No evidence of irreparable harm where adult entertainment store litigated applicability of zoning ordinances]; Nobu Next Door, LLC v. Fine Arts Housing, Inc. 4 NY3d 839 [2005] [The decision whether to grant or deny provisional relief rests within the sound discretion of the lower court]; Matter of JC and AC v. Oakfield-Alabama CSD et al. [Supreme Court, Genesee County Index No. E72845] [Matter pending and involving same petitioner's attorney and doctor of osteopathy]).

In Matter of Peter and Elizabeth Tower Foundation v. Doyle, et al. (204 AD2d1460 [4th Dept. 2022]), the Fourth Department noted that "Because preliminary injunctions prevent the litigants from taking actions that they are [*4]otherwise legally entitled to take in advance of an adjudication on the merits, they should be issued cautiously (citation omitted) . . . . We have therefore advised that preliminary injunctive relief is 'a drastic remedy' not routinely granted" (citations omitted).

Applying this law to the facts at bar, petitioner argues that she is "being deprived of her right to a free public education and is suffering emotional distress and educational loss that is ongoing and irreversible." Admittedly, participating in the senior year of high school with a student's friends and peer group is an emotional rite of passage, and it costs nothing other than continued payment of taxes. However, it cannot be denied that the educational aspect of high school is a student's top priority. As such, there appears to be no immediate and irreparable injury, loss or damage. Either petitioner continues to be home-schooled, or she returns to school to complete her diploma requirements in several months after she turns 18 and is no longer subject to the legal strictures at bar. Simply put, delaying completion of the senior year in high school, or replacing the final school year in a non-social setting such as home schooling, does not rise to the level of immediate and irreparable injury, loss or damage.

Because this Court holds that one of the three prongs required to grant injunctive relief —irreparable harm —is lacking, this Court does not address the remaining two prongs while addressing the motion for a preliminary injunction. Rather, those two prongs: Likelihood of success on the merits, and balancing of the equities will be addressed next in the final section of the analysis.

CPLR 7803 (1) and (3) permits a court to grant relief if an administrative agency failed to perform a duty enjoined upon it by law, or if a determination was made in violation of lawful procedure; an error of law; arbitrary or capricious; or an abuse of discretion.

In Matter of Pell et al. v. Board of Education (34 NY2d 222 [1974]), the state's highest court held that courts have no right to review the facts generally, beyond seeing to it that there is "substantial evidence" (citation omitted). The approach is the same when the issue concerns the exercise of discretion by the administrative tribunal. The courts cannot interfere unless there is no rational basis for the exercise of discretion, or the action complained of is "arbitrary and capricious" (citations omitted). The arbitrary or capricious test chiefly relates to whether a particular action should have been taken or is justified, and whether the administrative action is without foundation in fact. Arbitrary action is without sound basis in reason and is generally taken without regards to the facts. The [*5]proper test is whether there is a rational basis for the administrative orders (citations omitted).

Applying the law to the facts, it is plainly evident that the principal and School District's actions were grounded in sound reasoning, i.e. that there were no valid contraindicated grounds in Dr. Riccione's letter of exemption. The applicable statutory regulation (10 NYCRR 66-1.1) requires a medical contraindication, and further, authorizes the principal or person in charge to require additional information supporting the exemption. This was not satisfied. The physician's letter of exemption is plainly not a ministerial act. It is so much more. It must rise to the level of medical contraindication, and without more, becomes a toothless plea.

Furthermore, a review of the equities —and a balancing of the equities —leads this Court to the most determinative and compelling aspect of the analysis, namely the affirmations of the petitioner's medical expert (NYCEF # 57) and respondents' medical expert (NYCEF # 51). In sum and substance, petitioner's expert averred that the vaccine at issue does not prevent transmission of meningitis in a school setting, and that in 2023, there were a total of only 43 cases of meningococcal disease among high school-aged students in the entire United States. Respondents' expert averred that meningitis is an inflammation of the membranes around the brain and spinal cord that can be fatal or result in serious complications of the infected individual. Meningitis, according to the expert, is easily and rapidly transmissible through close contact with an infected individual through coughing, sneezing, kissing, or sharing food or drinks —all of which are common with student populations. Once present within a student population, meningitis can spread quickly. The meningococcal vaccine not only acts to protect the individual receiving the vaccine, but to protect those around the individual by making it much less likely that meningitis will spread through a student population. In other words, this is a battle of the experts.

The Court has attempted to verify both experts' statistics and it appears that petitioner's statistic from a CDC report at paragraphs 11 and 12 presents only a partial picture, and further, reference to the Vaccine Adverse Event Reporting System (VAERS) is misplaced. First, petitioner's expert lists 43 "cases" of meningococcal disease amongst 11- to 23-year-olds in 2023 in the United States, and "zero deaths" among the same age group that year. That describes only a small portion of the statistics, however. This Court's reading of that report, "2023 EMDS Surveillance Report" shows —among all ages— 437 cases of meningococcal disease in the nation in 2023 (see appendix to this Decision, cached at https://www.nycourts.gov/reporter/webdocs/2023EMDSSurveillanceReport.pdf). Moreover, the report shows of those 437 cases, 46 patients actually died from the disease. This is a 10% fatality ratio —to say nothing of the harms from being infected by the disease and then surviving Accordingly, it appears that select data from the report has been cherry-picked in order to support the expert's conclusion.

Furthermore, petitioner's reference to countless "reactions" to the vaccine —and a remarkable 290 deaths from vaccine —appears questionable. The "Vaccine Adverse Event Reporting System" (VAERS) is criticized by academics as unverified and unreliable raw data ("Don't fall for the VAERS scare tactics." "The Vaccine Adverse Event Reporting System is being misused by anti-vaxxers to terrify the public [www.mcgill.ca]; "Anti- vaccination fringe groups have attempted to spin false stories using VAERS data, adding to misinformation . . . .[publichealth.jhu.edu]). Accordingly, petitioner's medical affidavit is rife with infirmity.

According to the New York State Department of Health Meningococcal Disease Fact Sheet, 10-15% of those who get meningitis die. Among survivors, as many as 1 in 5 will have permanent disabilities. Complications include hearing loss; brain damage; kidney damage; nervous system problems; and limb amputations (www.health.ny.gov/publications/2168).

When asked at oral argument if 43 instances of transmission were acceptable, or where should the line be drawn, petitioner's counsel demurred. Thus the most relevant question in this entire exercise should be, at what point does the risk of transmissibility of a potentially fatal and wicked disease outweigh the individual right of a high school student to go unvaccinated, while surrounded by hundreds or thousands of fellow students, teachers, and staff ? Petitioner has every right to refuse the vaccine. But she does not have the right to attend school unvaccinated and risk exposure of meningitis —no matter how arguably small —to her classmates, teachers and staff. As a result, the balance of the equities clearly weighs in favor of the mitigation of risk of transmission. One transmission of meningitis is too much. The petition is therefore denied.

Respondents are directed to order the transcript of oral argument and attach it to the proposed Order, which shall reference the transcript, and be submitted on notice to opposing counsel within 30 days to the Court.