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The U.S. Supreme Court on Monday declined to issue an injunction against New York’s COVID-19 vaccine mandate for health care workers, which doesn’t allow them to seek a religious exemption.

New York state imposed the vaccine mandate for doctors and nurses in August, which allows only for medical exemptions, not religious ones. The religious exemption policy expired in November.

The latest decision suggests the high court lacks the appetite to wade into the matter of mandates. The Supreme Court has previously rejected other challenges, including one that focused on Maine’s lack of a religious exemption to vaccine mandates for health care workers.

Petitioners, which included Christian doctors, said New York’s vaccine mandate violates the U.S. Constitution’s First Amendment prohibition on religious discrimination on behalf of the government. They also argued that it violates federal civil rights law that requires businesses to accommodate employees’ religious beliefs.

Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch wrote they would have supported temporarily halting enforcement of New York’s mandate.

“Sometimes dissenting religious beliefs can seem strange and bewildering. In times of crisis, this puzzlement can evolve into fear and anger,” Gorsuch wrote in his dissent.

“One can only hope today’s ruling will not be the final chapter in this grim story,” Gorsuch continued. “Cases like this one may serve as cautionary tales for those who follow.”

In October, when the Supreme Court didn’t take up the Maine vaccine case, Gorsuch wrote that “healthcare workers who have served on the front line of a pandemic for the last 18 months are now being fired and their practices shuttered,” adding that they have been terminated “for adhering to their constitutionally protected religious beliefs.”

“Their plight is worthy of our attention,” he argued.

Other than Maine and New York, Rhode Island is the only other state that doesn’t allow religious exemptions to the vaccine for health care workers.