November 10, 2020

Can I Make Vaccines Mandatory for My Employees?

doctor injects healthcare worker with vaccine

Note: We are actively monitoring the EEOC’s guidance on COVID vaccines. We anticipate that it will be substantially similar to their flu vaccine guidance, but will be watching carefully for additional guidance as it rolls out. Click here and sign up to receive updates in your inbox as they become available.

With the start of flu season during a global pandemic, it is as important as ever that employers understand their rights and obligations surrounding vaccines. Not surprisingly, the CDC is stressing the importance of the flu vaccine this year, calling it an “essential part” of protecting you and your family’s health this season

Even so, a large percentage of people do not get the flu shot. And with the COVID-19 vaccine hopefully coming around the corner, we know the question on every employer’s mind is “Can I require my employees to get the flu shot or the COVID-19 vaccine once it’s available?”

Ultimately, the answer to this question isn’t as much about what you can do, but rather what you should do. While employers can require vaccines in most cities/states, the potential repercussions, both legally and practically, are severe enough that you definitely want to think twice before enforcing this type of policy. 

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So what should I do?

For most employers, the right answer to this question is likely in line with EEOC guidance on this topic: you should consider simply encouraging employees to get the vaccine rather than requiring them to take it.

One of the best ways to incentivize employees to be vaccinated is to make it as convenient as possible by scheduling an on-site clinic at the workplace that offers the vaccinations for free.    You can also educate your team on the importance of being vaccinated during meetings or through posters and pamphlets, as well as by providing them with information on exactly where they can go in your community to get the vaccine.   

The CDC has a plethora of information on Promoting Vaccination in the Workplace, including a vaccine declination form for healthcare workers.  


What’s wrong with just requiring the vaccine?

To begin with, there are some cities and states that prohibit mandatory vaccinations in some situations, so you should check your local laws first. These laws generally apply to hospital workers and either require them to have certain vaccinations, prohibit the employer from requiring vaccinations, or require the employer to offer free vaccinations. To help with this research, here is a list of state immunization laws for hospital workers created by the CDC. 

There are also some federal laws that make mandatory vaccinations tricky.  Both the Americans with Disabilities Act (ADA) and Title VII of the Civil Rights Act of 1964 (Title VII) provide protections for employees who are adverse to being vaccinated. They apply to employers with 15 or more employees, but many states have similar laws that apply to smaller employers.   

Under the ADA, employees have a right to an exemption if they have a disability that prevents them from getting immunized. Similarly, under Title VII, an employee with a sincerely held religious belief against immunizations is entitled to a reasonable accommodation.  

By requiring vaccinations, you may end up forcing an employee to tell you about a medical or religious issue that you may not otherwise have any reason to know about. This just adds extra, unnecessary layers of protection for the employee in this situation.  

The way this usually plays out is that an employee will say that they have an immune deficiency or allergy that prevents them from being vaccinated, or that they are part of the Church of Christ, Scientist or the Dutch Reformed Church (the two religious groups in the US that openly discourage vaccination).  

When an employee presents this type of issue with getting a vaccine, most employers simply note that in their records and move on. However, as a healthcare employer, you may have heightened concerns around the risks unvaccinated employees pose in the office. 

If this is the case, you can’t simply turn around and fire them or force a vaccine on them. Because they are raising issues protected by law, you need to engage in an interactive process with these employees to determine whether there is a reasonable accommodation you can provide. 

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You are able to ask the employee to verify their need for an exemption from the vaccination requirement, most likely with a letter from their church leader or doctor. Next, you will want to determine if there’s an alternative way of protecting against the flu for this employee. 

Common solutions include having the employee wear a mask or other PPE while working with patients to help minimize the risk of spreading the virus. During the COVID-19 pandemic, you’re likely already doing this in your practice. In other cases, particularly if there isn’t appropriate PPE available or if you work with high-risk patients, you could make a change in that employee’s job duties.

We highly recommend looking at these alternative solutions. Otherwise, your last remaining option may be to terminate their employment, but that is extremely risky to do when the employee has raised a medical or religious issue. You can only legally decline to accommodate and, instead, terminate employment if you can show that doing anything else would pose an “undue hardship” on the company.  

As you might imagine, establishing an undue hardship is a murky legal endeavor that can lead to years of litigation, even when it’s done properly. It’s best to avoid backing yourself into this corner, if at all possible. 

Another way this whole process can easily become even more complicated is by inviting unwanted discussions about whether or not people “believe in” or support vaccines. Absent a medical or religious reason for those concerns, those beliefs aren’t protected by law. 

That being said, it’s not a can of worms you want to open at work. Not only are these discussions controversial and distracting but, when mixed with a mandatory vaccine policy, they could become protected under the National Labor Relations Act, a law that protects an employee’s right to discuss workplace conditions with coworkers. 


Hospitals require employees to get flu shots — why shouldn’t I?

Hospitals and other large healthcare facilities are typically subject to their own set of state laws that don’t apply to smaller facilities. This may include mandates that hospital employees stay current on certain vaccinations.

It may also be the case that employees in these facilities are simply strongly encouraged — not required — to get certain vaccines. And the persistence of exposure to pathogens in hospitals may serve as enough motivation for those employees to choose to get vaccinated, whether or not it is legally required of them.


What if I still want to require a vaccine?

If you feel that you have a compelling enough reason to justify mandating vaccinations for your employees despite all of the aforementioned drawbacks, here is what you need to know:

  • You need to pay for the cost of the vaccine and for the employee’s time spent getting the vaccine.
  • The requirement to get the vaccine needs to be directly tied to the employee’s job duties/description. In other words, there needs to be an objective, job-related reason for requiring a specific vaccine.
  • You need to consistently enforce your vaccine policy. 
  • If an employee requests a religious or medical accommodation, you need to follow the accommodation process described above diligently and ensure employees are not retaliated against in any way for bringing their concerns forward or discussing them with other employees. Even the appearance of retaliation will get you in trouble. 
  • All vaccination records should be included in a separate personnel file designated for confidential medical information. 
  • Create a written policy that explains the compelling reason for requiring the vaccine, the process, confidentiality measures, and how to seek a medical or religious accommodation. 

This article discusses vaccines, not COVID testing or other screening procedures.  For more information on these topics, check out our resource page on How to Handle COVID Exposure in Your Office

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This post authored by CEDR Compliance Officer Nora Gustafson.

Updated November 10, 2020; originally published October 27, 2020

Friendly Disclaimer: This information is general in nature and is not intended to provide legal advice or replace individual guidance about a specific issue with an attorney or HR expert. The information on this page is general human resources guidance that is believed to be current as of the date of publication. Note that CEDR is not a law firm, and as the law is always changing, you should consult with a qualified attorney or HR expert who is familiar with all of the facts of your situation before making a decision about any human resources or employment law matter.