Many health care employers require employees with patient contact to obtain various vaccinations as a condition of employment. Occasionally, employees or applicants will decline the vaccines and request an exemption based on health or religious reasons. As demonstrated by a recent Eighth Circuit Court of Appeals decision, courts generally defer to the employer’s determination about the need for such vaccinations.

In Hustvet v. Allina Health System, the employer required newly acquired employees to obtain the MMR vaccine. The plaintiff claimed that she already had mumps and measles and therefore had natural immunity. She stated that she suffered from multiple allergies and chemical sensitivities but would obtain a rubella-only vaccine. This vaccine is not available, and the employer concluded that the plaintiff abandoned her job when she refused to obtain the MMR vaccine. She sued, claiming failure to accommodate under the ADA.

The Eighth Circuit affirmed dismissal of the suit on multiple grounds. First, the plaintiff’s assertion of general allergies did not demonstrate a significant impairment of a major life activity, meaning that she was not disabled as defined under the ADA. Second, even if considered protected, the employer demonstrated business necessity for the vaccine requirement: in this case, protection of expectant mothers from potentially harmful pathogens. Finally, the court rejected the plaintiff’s retaliation claim on the basis that she could not show evidence of pretext behind the employer’s decision.

When this type of question arises, health care employers should understand that employees have very limited legal grounds on which to claim exemption from vaccination requirements. In most situations, courts and the EEOC will place public health concerns over the individual employee’s arguments for avoiding the vaccinations.