25-1316-cv A.A.C., et al. v. Starpoint Central School District, et al.
UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT
SUMMARY ORDER
RULINGS BY SUMMARY ORDER DO NOT HAVE PRECEDENTIAL EFFECT. CITATION TO A SUMMARY ORDER FILED ON OR AFTER JANUARY 1, 2007, IS PERMITTED AND IS GOVERNED BY FEDERAL RULE OF APPELLATE PROCEDURE 32.1 AND THIS COURT’S LOCAL RULE 32.1.1. WHEN CITING A SUMMARY ORDER IN A DOCUMENT FILED WITH THIS COURT, A PARTY MUST CITE EITHER THE FEDERAL APPENDIX OR AN ELECTRONIC DATABASE (WITH THE NOTATION “SUMMARY ORDER”). A PARTY CITING A SUMMARY ORDER MUST SERVE A COPY OF IT ON ANY PARTY NOT REPRESENTED BY COUNSEL.
At a stated term of the United States Court of Appeals for the Second Circuit, held at the Thurgood Marshall United States Courthouse, 40 Foley Square, in the City of New York, on the 16th day of January, two thousand twenty-six.
PRESENT: GUIDO CALABRESI, GERARD E. LYNCH, SARAH A. L. MERRIAM, Circuit Judges.
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A.A.C., T.C. EX REL. A.C., G.C., Plaintiffs-Appellees, v. 25-1316-cv
STARPOINT CENTRAL SCHOOL DISTRICT, DR. SEAN CROFT, INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY, MAUREEN BRAUNSCHEIDEL, INDIVIDUALLY AND IN HER OFFICIAL CAPACITY, DR. ALAN INGRAHAM, INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY, DR. COREY GRAY, INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY, DR. THOMAS SZALKOWSKI, INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY, FRAN ANDERSON, INDIVIDUALLY AND IN HER OFFICIAL CAPACITY, JOHN ANDREWS, INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY, VINCENT DELL’OSO , INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY, JOHN DOE(S), INDIVIDUALLY AND IN THEIR OFFICIAL CAPACITIES, Defendants-Appellants.*
For Defendants-Appellants: MICHAEL P. MCCLAREN, Gross Schuman, P.C., Buffalo, NY; Meghan M. Hayes, Webster Szanyi LLP, Buffalo, NY.
For Plaintiffs-Appellees: R. ANTHONY RUPP III (Paul D. Jager, on the brief), Rupp Pfalzgraf LLC, Buffalo, NY; Chad A. Davenport, Davenport Law PLLC, Hamburg, NY.
Appeal from the United States District Court for the Western District of
New York (John L. Sinatra, District Judge).
UPON DUE CONSIDERATION, IT IS HEREBY ORDERED,
ADJUDGED, AND DECREED that the appeal is DISMISSED as moot.
Plaintiffs-Appellees are parents of a minor child, A.C., who started sixth
grade at Starpoint Middle School in the 2024–2025 school year. Defendants-
Appellants, the Starpoint Central School District and some of its officials, appeal
from an expired preliminary injunction that enjoined them from excluding A.C.
from school for her failure to comply with immunization requirements. We
assume the parties’ familiarity with the underlying facts, the procedural history,
* The Clerk of Court is respectfully directed to amend the caption as reflected above.
2 the arguments presented on appeal, and the district court’s rulings.
I. BACKGROUND
A. Statutory and Regulatory Framework
New York Public Health Law § 2164 sets up an immunization schedule for
all school-attending children. See N.Y. Pub. Health Law § 2164(2)(a)–(c). Among
other required vaccines, a child must be vaccinated against tetanus, diphtheria
and pertussis, commonly through a combined “Tdap” vaccine, when the child
first attends school, and through a booster when the child enters the sixth grade.
See id. Section 2164 prohibits any school from admitting children not so
immunized. See id. § (7)(a).
Those requirements do not apply “[i]f any physician licensed to practice
medicine in [New York] certifies that such immunization may be detrimental to a
child’s health,” and “until such immunization is found no longer to be
detrimental to the child’s health.” Id. § (8). The statute does not define the phrase
“may be detrimental to a child’s health,” but it does delegate general rulemaking
authority to the Commissioner of Health, authorizing the commissioner to
“adopt and amend rules and regulations to effectuate the provisions and
purposes of [§ 2164].” Id. § (10); see also id. § 206(1)(l) (tasking the Commissioner
3 of the New York State Department of Health with establishing and operating
child immunization programs).
An implementing regulation defines the phrase “[m]ay be detrimental to
the child’s health” to “mean[] that a physician has determined that a child has a
medical contraindication or precaution to a specific immunization consistent with
[Center for Disease Control and Prevention’s Advisory Committee on
Immunization Practices (“ACIP”)] guidance or other nationally recognized
evidence-based standard of care.” N.Y.C.R.R. tit. 10, § 66-1.1(l). For the Tdap
vaccine, ACIP guidelines consider, in relevant part, a “[p]rogressive or unstable
neurological disorder” as one precaution “until a treatment regimen has been
established and the condition has stabilized.” App’x 1460.
The regulations further prohibit schools from admitting an unvaccinated
child unless the child provides, in relevant part, “[a] signed, completed medical
exemption form approved by the [New York State Department of Health
(“NYSDOH”)] . . . from a physician licensed to practice medicine in New York
State certifying that immunization may be detrimental to the child’s health.”
N.Y.C.R.R. tit. 10, § 66-1.3(c). The form must “contain[] sufficient information to
identify a medical contraindication to a specific immunization and specify[] the
length of time the immunization is medically contraindicated.” Id.
4 Upon receiving the exemption request, the school “may require additional
information supporting the exemption.” Id. Recognizing that “[s]chools are on
the front[]lines in the defense against vaccine[-]preventable diseases,” NYSDOH
tasks schools with “the responsibility to reject immunization records [the schools]
believe to be fraudulent based on their knowledge and assessment of the facts.”
App’x 1536. NYSDOH instructs schools on spotting “Red Flags that warrant
further investigation,” such as identifying “a provider with a known history of
vaccination fraud” or who “do[es] not follow the norm when it comes to
administering vaccines or medical exemptions,” or a student who “submit[s] the
same medical exemption annually with a contraindication . . . that is not valid
according to [ACIP guidelines].” Id.
B. Factual and Procedural Background
In the fall of 2024, A.C. started sixth grade and was due to receive a Tdap
booster. Plaintiffs submitted a medical exemption request on her behalf, which
was issued by an out-of-state practitioner and broadly asserted that A.C. was
permanently exempt from any vaccinations. Defendants denied the request and
informed plaintiffs that A.C. would be excluded from school beginning on
5 October 15, 2024, unless she received the vaccine by then.2 Plaintiffs petitioned
the Commissioner of Education for review of the denial, to no avail.
Plaintiffs did not seek further review of that denial in state court. Instead,
on October 28, 2024, they brought this action in the United States District Court
for the Western District of New York. The parties stipulated that A.C. could
return to school until her scheduled doctor’s appointment on December 3, 2024.
On that day, a New York-licensed physician, Dr. Joseph A. Riccione, issued a
medical exemption for A.C. The exemption describes A.C.’s adverse reaction to
the vaccine in the form of “neurological vocal and motor tics,” which “ha[d] been
chronic” since A.C. first received the vaccine in 2018, and concludes that the “tics
constitute a neurological disorder which falls under a valid ACIP
precaution/reason for exemption.” Id. at 205.
After receiving the exemption, defendants requested pertinent office visit
notes regarding the diagnosis, and plaintiffs refused. Defendants then consulted
NYSDOH, which responded that, according to ACIP, “vocal and motor tics are
not contraindications or precaution[s] to Tdap.” Id. at 1264. Defendants denied
2 Around the same time, defendants also denied an exemption request plaintiffs submitted on behalf of G.C., A.C.’s elder sister, after discovering that plaintiffs had altered G.C.’s vaccination record.
6 the request and notified plaintiffs that A.C. could not attend school starting
January 2, 2025.
Plaintiffs did not seek review of that denial by the Commissioner of
Education. On December 29, 2024, they amended their federal complaint,
asserting various federal statutory and constitutional claims, and a state
constitutional claim. They also sought a temporary restraining order and a
preliminary injunction. The district court temporarily restrained defendants from
excluding A.C. from school until the disposition of the preliminary injunction
motion.
After conducting an evidentiary hearing and reviewing supplemental
briefing, the district court granted plaintiffs’ motion for a preliminary injunction
on April 25, 2025. Notably, the district court rejected all of plaintiffs’ pleaded
claims as unlikely to succeed on the merits, but discovered an unpleaded state-
law claim which, the court believed, was likely to succeed. The unpleaded claim
in which the district court found merit was based on New York statutory law, on
the theory that the defendants’ denial of A.C.’s exemption, and perhaps the
regulations on which they relied, was contrary to the mandate of § 2164, because
the defendants denied “the facially and procedurally valid exemption request
7 that Dr. Riccione completed on A.C.’s behalf.” Special App’x 22.
To pursue such a claim in New York state court, a parent would ordinarily
first petition the Commissioner of Education. See N.Y. Pub. Health Law
§ 2164(7)(b). If unsuccessful, the parent could challenge the commissioner’s
denial as arbitrary and capricious in the appropriate New York supreme court
pursuant to Article 78 of New York’s Civil Practice Law and Rules. See
N.Y.C.P.L.R. § 7804(b). Appellate courts in New York have yet to adjudicate such
a claim on the merits. See Coritsidis v. New York City Department of Education, 242
A.D.3d 886, 888 (2d Dep’t 2025) (affirming the supreme court’s denial of a
parent’s direct challenge to a school’s exemption denial under Article 78 for
failure to exhaust administrative remedies, without reaching the merits). The
only reported trial court decision addressing a similar claim rejected it on the
merits. See Lynch v. Clarkstown Central School District, 590 N.Y.S.2d 687, 690 (N.Y.
Sup. Ct. 1992) (holding that a school’s denial of a religious exemption after
investigating its basis was not arbitrary and capricious).
Despite the claim’s novelty and the important state interests it implicated,
the district court exercised its discretion to assert supplemental jurisdiction over
the claim. The district court declared defendants’ denial of A.C.’s request invalid,
8 relying not on any New York authority, but on this Court’s decision in Miller v.
McDonald, 130 F.4th 258 (2d Cir. 2025), cert. granted and judgment vacated, No.
25-133, 2025 WL 3506969 (U.S. Dec. 8, 2025), which it read as holding that New
York school officials lacked any discretion to approve or deny exemptions that
were backed by a proper form signed by a New York-licensed physician. Miller
addressed, however, not a denial of a medical exemption, but rather Free
Exercise Clause objections to New York’s repeal of religious exemptions to
immunization requirements. See 130 F.4th at 264–70. In the course of upholding
that repeal, we concluded that the state’s vaccination requirements remained
“neutral and generally applicable” because only “an ‘objectively defined’ group’”
of children in need of medical exemptions could obtain them. Id. at 268–69,
quoting We The Patriots USA, Inc. v. Hochul, 17 F.4th 266, 289 (2d Cir. 2021),
opinion clarified on other grounds, 17 F.4th 368 (2d Cir. 2021). In other words, school
officials did not have unfettered, “improper discretion” to shape the medical
exemption or create new exemptions however they wished, while excluding
religious exemption seekers. Id. at 269; cf. Fulton v. City of Philadelphia, 593 U.S.
522, 536–37 (2021) (striking down city actions that burdened religious freedom as
not “generally applicable” because the decision-making official had “sole
9 discretion” to grant individual exemptions).
Defendants timely appealed from the grant of the preliminary injunction.
The preliminary injunction, however, was short-lived. Although plaintiffs had
sought an injunction that would last through the final resolution of the case, the
district court set an expiration date at the earlier of either the resolution of the
case or the end of the 2024–2025 school year. That school year concluded on June
24, 2025, and the preliminary injunction expired.
II. DISCUSSION
The parties do not dispute that the expiration of the preliminary injunction
would ordinarily moot the appeal. Rather, they disagree on whether the capable-
of-repetition exception to mootness applies. That exception “‘applies only in
exceptional situations’ where ‘(1) the challenged action is in its duration too short
to be fully litigated prior to its cessation or expiration, and (2) there is a
reasonable expectation that the same complaining party would be subjected to
the same action again.’” Doe v. McDonald, 128 F.4th 379, 386–87 (2d Cir. 2025),
quoting Lillbask ex rel. Mauclaire v. State of Connecticut Department of Education, 397
F.3d 77, 85 (2d Cir. 2005).
We have cautioned, however, against invoking the capable-of-repetition
10 exception to review otherwise moot interlocutory appeals of preliminary
injunctions, for several reasons. See Independence Party of Richmond County v.
Graham, 413 F.3d 252, 256 (2d Cir. 2005). First, where the issues raised in the
appeal “remain pending before the district court,” they do not “evade review.”
Id. Second, the interlocutory appeal of a preliminary injunction is already an
exception to “the ordinary rule . . . that appellate courts review only ‘final
decisions’ of a lower court.” Id., quoting 28 U.S.C. § 1291. That exception should
not be expanded needlessly. Third, the review of a preliminary injunction,
especially on the likelihood-of-success prong, often “preempt[s] the district
court’s resolution of” the relevant claims. Id. at 257. When the challenged
injunction is still in force, that intrusion is justified to “prevent the injustice of
burdening a party with a manifestly erroneous decree.” Id. at 256. But once the
injunction expires, the risk of ongoing injustice diminishes; so does the need for
review. See id. at 256–57.
Defendants’ argument that the current case fits the capable-of-repetition
exception is not frivolous. A New York regulation requires that the medical
exemption “be reissued annually.” N.Y.C.R.R. tit. 10, § 66-1.3(c). In the abstract,
the limited duration of the remaining school year could be “too short to . . . fully
11 litigate[]” the challenged exclusion “prior to its . . . expiration.” Doe, 128 F.4th at
387 (internal quotation marks omitted). There can be “a reasonable expectation
that” the school may deny plaintiffs’ renewed exemption requests, plaintiffs may
move for another preliminary injunction, and that the district court may grant it
until the end of the next school year. Id. (internal quotation marks omitted). That
dispute might again fail to be resolved within that school year before the
injunction expires.
Events during the course of an ongoing litigation may evolve, however,
such that the contours of the dispute may change from one year to the next. That
is what happened in this case. Both the facts and the law relevant to the
preliminary-injunction dispute in this case now differ from those the district
court faced in the prior year, illustrating the reasons for the Independence Party
rule.
First, this year’s application appears to have taken a different path. For the
2025–2026 school year, Dr. Riccione first issued an exemption request for A.C. on
September 17, 2025, and then a second on November 12, 2025. See Exhs. A, C, to
Supplemental Brief for Appellants at 7, 12, A.A.C. v. Starpoint Central School
District, No. 25-1316 (2d Cir. Dec. 5, 2025), ECF No. 78. Both forms differ from the
12 one Dr. Riccione issued for the previous year in two respects: they address not
only the Tdap vaccine but also the Meningococcal vaccine;3 and they describe
A.C.’s tic disorder, on which the doctor had relied in the previous year, as
“[u]nstable” instead of “chronic.” Compare id. at 12 with App’x 205.
Moreover, while defendants had denied the September 17 request and
represented to us at oral argument that they anticipated denying the November
12 one, they permitted A.C. to attend school pending their review of the second
application, instead of excluding A.C. right away. Supplemental Brief for
Appellants at 2, No. 25-1316; Oral Argument at 41:35–42:03, A.A.C. v. Starpoint
Central School District, No. 25-1316 (2d Cir. Dec. 9, 2025). Nor did plaintiffs seek a
preliminary injunction to challenge the denial of the September 17 request as they
had done the previous year;4 they may yet choose to exhaust their administrative
3 ACIP does not list any neurological disorder as a contraindication or precaution to MenACWY, the common vaccine against Meningococcal disease. App’x 1459. 4 Plaintiffs sought a temporary restraining order and a preliminary injunction at the beginning of the 2025–2026 school year, but solely to enjoin defendants from excluding A.C. from school until A.C.’s annual physical examination, prior to the issuance or submission of any exemption request. The district court did not immediately grant that relief in reliance on its prior decision. Rather, it denied the motion for a temporary restraining order and referred the motion for a preliminary injunction to a Magistrate Judge for a
13 remedies and seek review in state courts, whose decisions are not subject to our
review.
Second, the legal landscape has also shifted by virtue of factual
developments. In the 2024–2025 school year, defendants’ rejection of the
exemption request turned on their conclusion that the certification, on its face,
did not diagnose A.C. with a condition covered by the ACIP guidance, which
New York regulation required for a finding that the Tdap vaccine “may be
detrimental to the child’s health.” N.Y.C.R.R. tit. 10, § 66-1.1(l). Plaintiffs’
challenge of that denial under § 2164, at least in part, questions whether the
regulatory definition of “detrimental” conflicted with the governing state statute.
However, the 2025–2026 requests, insofar as they sought an exemption from the
Tdap vaccination,5 describe an unstable neurological disorder that facially falls
within an ACIP “precaution.” Their validity thus more squarely presents the
issue of whether defendants may question the reasonableness, good faith, or
accuracy of the certifying doctor’s diagnosis.
report and recommendation. The Magistrate Judge has not taken action on the matter, and it is unclear whether the plaintiffs continue to seek that relief. 5 The current exemption forms also cover a different vaccination, raising entirely separate questions not addressed at all in the 2024–2025 litigation.
14 Moreover, while there remains no New York authority interpreting the
requirements of § 2164 as rigidly as did the district court, the principal authority
on which the district court relied to support its reading, our decision in Miller, is
no longer a part of the legal landscape. The Supreme Court vacated that decision
and remanded the case for reconsideration. See Miller v. McDonald, No. 25-133,
2025 WL 3506969, at *1 (U.S. Dec. 8, 2025). The case remains pending before
another panel of this Court. Thus, the principal authority on which the district
court relied, rightly or wrongly, for its interpretation of the New York statute, no
longer exists.
As a result, the repetition of the same legal dispute that the district court
decided in issuing the expired 2024–2025 injunction, based on the record before it
at the time it ruled, is at best “highly speculative.” Doe, 128 F.4th at 387. Whether
defendants must accept A.C.’s exemption request under New York law will
return to us only if plaintiffs again seek to short-circuit the Article 78 process and
rush straight to federal court, and the district court grants another preliminary
injunction for the 2025–2026 school year despite the vacatur of Miller. And even if
the dispute reaches us again, we would face different issues against a different
factual and legal backdrop, as Dr. Riccione’s description of A.C.’s medical
15 condition has shifted. Adjudicating the correctness of the expired injunction
promises no concrete relief but risks “advising what the law would be upon a
hypothetical state of facts.” Chafin v. Chafin, 568 U.S. 165, 172 (2013), quoting
Lewis v. Continental Bank Corp., 494 U.S. 472, 477 (1990). Thus, even if the rule of
Independence Party is not absolute, this case fits neatly within its logic, and does
not fall under any hypothetical exception to it.
* * *
For the foregoing reasons, the instant appeal does not present a live case or
controversy, and accordingly is DISMISSED as moot.
FOR THE COURT: Catherine O’Hagan Wolfe, Clerk