Vaccine Mandates: What to Know

As COVID-19 vaccination efforts continue, some cities, states, businesses, schools, universities, and even the federal government are turning toward mandating, or requiring, vaccines.

Is that legal? Here’s what we know.

What Is a Vaccine Mandate?

It’s a requirement that says you must be vaccinated to do certain things like working, traveling, or even attending a concert.

But the government or other authorities can’t physically force you to get vaccinated. A vaccine mandate just means that if you don’t, businesses, schools, and others can legally stop you from entering the building or using their services if they choose to.

Vaccine mandates aren’t new. All states require certain vaccinations before children start school, with few exemptions or the ability to opt out. And some vaccinations are required for legal immigration or international travel.

Is There a Federal Mandate for COVID-19 Vaccines?

Yes. President Joe Biden recently required all employers with 100 or more employees to make sure their workers receive the vaccine or have a COVID-19 test weekly. The Department of Labor’s Occupational Safety and Health Administration (OSHA) continues to work on a rule to enforce this. OSHA will also enforce a rule that requires these companies to provide paid time off for the time it takes workers to get the vaccine and recover from any symptoms.

In the meantime, OSHA will issue an Emergency Temporary Standard (ETS) to impose this mandate. 

In addition to the president’s announcement in July about strengthening safety requirements for unvaccinated federal workers, he has signed an Executive Order to require all federal executive branch workers to receive the vaccine. President Biden also signed an Executive Order that requires this mandate for employees of contactors that do business with the federal government.

The Center for Medicare and Medicaid Services (CMS) plans to require health care workers at most Medicare and Medicaid participating facilities to receive the vaccination.

The president has also called on entertainment venues and other areas with large groups of people to require that people be vaccinate or show a negative test for entry.

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What About a State or City Mandate?

Yes. According to the U.S. Supreme Court, states and cities can require vaccine mandates in certain instances.

California became the first state to mandate all state and health care workers to show proof of COVID-19 vaccination or be tested at least once a week. And Hawaii allows fully vaccinated individuals to avoid certain COVID-19 restrictions.

Several states, including Alabama, Florida, and Georgia, have banned state and local authorities from mandating COVID-19 vaccines or requiring proof of vaccination.

Employers and Vaccine Mandates

The Equal Employment Opportunity Commission (EEOC) says employers may mandate COVID-19 vaccines or ask for proof of vaccination. But the employer’s policies must meet Americans with Disabilities Act (ADA) or Title VII of the Civil Rights Act of 1964 requirements and provide reasonable accommodations. And other laws not related to EEOC may affect this.

Exemptions may include:

  • Sincerely held religious beliefs
  • Medical restrictions like an allergy or bad reaction to a vaccine

However, the EEOC also says reasonable accommodations aren’t necessary if the employer deems something a direct threat to other employees and the business itself.

Companies like Google, Facebook, Netflix, and Lyft already have vaccine mandates in place. And many hospitals require workers to get vaccinated.

Religious Exemptions From COVID-19 Vaccine

The rules around asking for religious exemptions from getting the COVID-19 vaccine can be confusing and a bit complicated.

The U.S. Equal Employment Opportunity Commission (EEOC) says all employers, including state and local government employers, with 15 or more employees are covered under Title VII of the Civil Rights Act of 1964.

Title VII requires employers to reasonably accommodate an applicant or employee if the person requests an exception from vaccination requirements that conflict with their sincerely held religious beliefs, practices, or observances. There are guidelines that both employers and employees have to follow under Title VII.

Those include:

  • Employees must inform their employers if they want a religious exemption based on beliefs, practices, or observance.
  • Employers must consider religious exemptions on an individual basis. That does not cover or protect the employee’s social, political, or economic views about the COVID-19 vaccination requirement.
  • Employers who can prove “undue hardship” -- be it financial or operational -- are not required to accommodate an employee’s religious exemption request.

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How to submit a request for a religious exemption

Each employer may have their own methods or policies for submitting a religious exemption request. They may include a religious exemption form to sign or a detailed letter to your manager or the human resources department.

Once your employer is notified, they may engage in a process including you and maybe your religious leader to share an explanation about the need for a religious exemption. This is called an interactive process, a “good-faith” effort from everyone involved to discuss and evaluate the potential need for an exemption.

The employer may also ask you for more information to further review whether the exemption is based on sincerely held beliefs.

This can include:

  • How long you’ve held the religious belief you’re using to request the exemption
  • Whether your request for a religious exemption is for all vaccines, COVID-19 vaccines, a specific type of COVID-19 vaccine, or some other category of vaccine
  • Whether you have received other vaccines as an adult, such as flu or tetanus shots

After you’ve submitted the request through a form or letter and provided any additional information, the employer will assess the request. They may approve or deny it based on the information you provide.

If your exemption is approved under EEOC laws and Title VII, your employer may provide reasonable alternatives to getting a COVID-19 vaccine. Accommodations can mean unvaccinated employees:

  • Wear a face mask at work
  • Work at a social distance from co-workers and others
  • Work a modified shift to reduce chances of spreading the virus
  • Get COVID-19 tests periodically to keep co-workers safe
  • Get the option to work remotely
  • Accept a reassignment of job duties

Schools/Universities and Vaccine Mandates

It’s important that parents get their children vaccinated against COVID-19 if they’re over 12 years old and eligible. But for those who are too young to receive the vaccination, it’s important that they’re surrounded by vaccinated people, especially in schools.

President Biden called for all governors to require vaccinations for teachers and other school staff. So far, nine states, as well as the District of Columbia and Puerto Rico, enforce COVID-19 vaccination requirements for staff members at K-12 schools. They include:

  • California
  • Connecticut
  • Hawaii
  • Illinois
  • New Jersey
  • New Mexico
  • New York
  • Oregon
  • Washington

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The president also recently required that teachers and staff at Head Start and Early Head Start programs, Department of Defense (DOD), and the Bureau of Indian Education-operated schools get vaccinated.

The Department of Health and Human Services (HHS) will introduce these policies for Head Start and Early Head Start programs, which provide education and development services to ensure that children are prepared for kindergarten.

The DOD runs 160 K-12 schools for military families while the Department of Interior manages 53 schools through the Bureau of Indian Education (BIE) around the U.S. on and off tribal lands.

Together, these schools and programs serve more than 1 million children every year and employ around 300,000 staff members. Vaccine requirements will allow these facilities to stay open safely and continue to provide for families who rely on their services.

More than 800 colleges and universities have now also adopted COVID-19 vaccination requirements for students and staff. Even many universities without vaccine requirements have encouraged or incentivized students to get vaccinated.

Vaccine exemptions for other immunizations vary from state to state. But all schools grant these exemptions to children for medical reasons. Forty-four states and Washington, DC, allow religious exemptions to vaccines while 15 states allow philosophical exemptions for kids whose parents reject vaccines for moral, personal, or other beliefs.

But many states choose to align their vaccine requirements with the CDC’s recommendations.

Can Bars or Restaurants Ask for Vaccine Proof or Deny Service?

The laws around this can be a bit confusing. The federal law states that private businesses can ask customers and employees about their vaccine status. They just have to be careful not to ask for other medical info.

However, some states like Florida have passed executive orders to stop businesses from asking customers about their COVID-19 vaccine status. But some San Francisco and New York bars and restaurants are asking customers for proof of vaccination or negative test results.

Tips to Safely Carry Your COVID-19 Vaccination Card

You may need to show proof of your vaccination to access certain activities and services like:

  • Traveling
  • Attending schools or universities
  • Employment
  • Large events or gatherings

Here are some tips to safely carry your card:

  • Take a photo of the front and back of your card. Keep it handy on your phone in case you may need to show it.
  • Don’t share it on social media. Your card may contain sensitive information like your name and date of birth.
  • Don’t laminate it. You may need booster shots in the future as experts learn more about the virus and the vaccines.
  • Download apps that can securely and digitally store your vaccination records in case you need to show proof.

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What to Do if You Lose Your COVID Vaccine Card

If you misplace your COVID-19 vaccine card, don’t worry. There are several options to ensure you can prove your status, if needed:

Check with your vaccine provider. You can check with wherever you received your vaccination, whether it be a retail pharmacy like CVS or Walgreens, or a health department. Many of these locations allow you to access your records online. Some also provide electronic copies of your vaccination card.

Check your email. If you signed up for your shot online and provided an email address, a vaccine record email should’ve appeared in your inbox after your shot.

Look up vaccination records. The CDC has access to your state’s health department Immunization Information System (IIS). You can look up and get a digital copy of your COVID-19 vaccination records after you verify some personal information.

What if You Don’t Comply With Vaccine Requirements?

If you decline to get the COVID-19 vaccination for reasons other than those related to religious or disability purposes, your company may choose to no longer employ you. Your specific situation will depend on your company’s guidelines and requirements.

Some companies will want to ensure your status. They may require you to show proof of COVID-19 vaccination or have employees complete weekly submissions of a COVID-19 test.

Guidelines change and update constantly. It’s important to check your company or school’s requirements to ensure you stay prepared.  

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on November 09, 2021

Sources

SOURCES:

U.S. Equal Employment Opportunity Commission: “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws,” “EEOC Issues Updated COVID-19 Technical Assistance.”

Saferederalworkforce.gov: “Request for A Religious Exception to The Covid-19 Vaccination Requirement.”

SHRM.org: “Employers React to Workers Who Refuse a COVID-19 Vaccination,” “Can Employers Mandate a Vaccine Authorized for Emergency Use?” “Employers React to Workers Who Refuse Vaccination as COVID-19 Cases Rise,” “How to Handle an Employee's Request for a Medical or Religious Accommodation to a Vaccine Requirement.”

Covid19vaccine.health.ny.gov: “Excelsior Pass.”

CDC: “Workplace COVID-19 Vaccine Toolkit,” “Myths and Facts about COVID-19 Vaccines.”

KFF.org: “Key Questions About COVID-19 Vaccine Mandates.”

Ca.gov: “Following Governor Newsom’s First-in-the-Nation Vaccination Measures, California Employers Follow Suit.”

Houston Methodist: “COVID-19 Vaccine Card: Do Keep It Safe, Don't Laminate It & Two More Do's & Don'ts.”

Uscis.gov: “vaccination requirements.”

Floridahealthcovid19.gov: “STATE OF FLORIDA OFFICE OF THE GOVERNOR EXECUTIVE ORDER NUMBER 21-81.”

Hawaii Tourism Authority: “Vaccination Exception Program for Hawaii-bound Travelers Vaccinated in U.S., Territories.”

Association of Flight Attendants-CWA, AFL-CIO: “What if you lose your vaccine card?”

National Conference of State Legislature: “States with Religious and Philosophical Exemptions From School Immunization Requirements.”

NPR: “Full FDA Approval Triggers More Universities To Require The COVID-19 Vaccine.”

WhiteHouse.gov: “Path Out of the Pandemic: President Biden’s Covid-19 Action Plan.”

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