States/ Local Governments Can Mandate Vaccinations
Over 100 years ago, the Supreme Court decided that states
can mandate that their citizens get vaccinated. In Jacobson v. Commonwealth
of Massachusetts (1905) 197 U.S. 11, the Court upheld a local law in
Cambridge, Massachusetts requiring inhabitants receive the smallpox vaccine.
The Court’s ruling relied on the principles that an individual’s right to
liberty and bodily autonomy is not absolute, and that states have the authority
to take actions necessary to protect the health and wellbeing of their citizens
(commonly referred to as states’ “police powers”).
The Supreme Court did not revisit government mandated
vaccinations again until 1922 in Zucht v. King (1922) 260 U.S. 174. The Zucht
Court held that mandating vaccines for only one group of people (in this
case school children), did not violate individuals’ Fourteenth Amendment rights
to due process or equal protection. This same logic would likely apply to a
mandate that first responders or public safety officers be vaccinated, even if
the same requirement is not applied to the general public.
More recently, multiple California appellate courts have
upheld Jacobson and Zucht, ruling that when it comes to mandatory
vaccinations, finding the need for public safety outweighs individuals’ rights
to privacy or bodily autonomy. In Brown v. Smith (2018) 24 Cal.App.5th
1135 and Love v. State Dept. of Education (2018) 29 Cal.App.5th 980, California appellate courts upheld
Senate Bill No. 277, which repealed the personal belief exemption to California’s
immunization requirements for school children. Thus, the courts limited the
exemptions available (once full FDA approval is received) to: 1) a sincerely
held religious belief, practice or observation; or 2) a medical accommodation.
There has been one court decision dealing with mandatory
COVID-19 vaccines. In Bridges v. Houston Methodist
Hospital (S.D. Tex., June 12, 2021,
No. CV H-21-1774) 2021 WL 2399994, Houston Methodist Hospital implemented a
policy requiring staff to be vaccinated or face termination. A number of
employees sued claiming wrongful termination after they refused to be
vaccinated. The court cited Jacobson as proof that an employer can
mandate vaccines. The court also dismissed the employees’ arguments that the
COVID-19 vaccine was distinguishable because it had only received “emergency”
approval. Ultimately, the court concluded: “Bridges
can freely choose to accept or refuse a COVID-19 vaccine; however, if she
refuses, she will simply need to work somewhere else... Every employment includes limits on the worker's behavior
in exchange for his remuneration. That is all part of the bargain.” (Id. at
p. *2.) It is important to note that this case dealt with a private employer.
However, the rationale is applicable to public employers and employees.
In another pending federal lawsuit, correctional employees brought
wrongful termination claims in challenging a directive requiring first
responders to be vaccinated as a condition of employment unless a reasonable accommodation
is approved. (Legarreta v. Macias, Case 2:21-cv-00179-MV-GBW (D.N.M.,
filed Feb. 28, 2021).) The court denied
the employees request for a restraining order on March 4, 2021, and the
Defendants have filed a motion to dismiss the case for failure to state a claim
and based on qualified immunity. The
motion to dismiss is fully briefed and a ruling could come as early as next
week.
It is well-settled law that state/local governments—and by
extension government employers—can mandate that citizens be vaccinated.
Further, the court rulings to date have applied these legal principles to
mandatory COVID-19 vaccines found in favor of the employer. However, this
authority is not absolute. Government employers may still be required to make
accommodations for individuals with sincere religious beliefs or medical
conditions that make vaccination a risk. The exemptions are discussed further
below.
Right to Bargain over the Impacts and Effects of Mandatory
Vaccinations
While
mandating vaccination is generally legal, the impacts and effects of such
a decision fall within the scope of bargaining. PERB recently held the
decision to adopt an influenza vaccination policy was outside the scope of
representation because the need to protect public health was not amenable to
collective bargaining or, alternatively, outweighed the benefits of bargaining
over the policy. However, the University’s implementation of the vaccination
policy constituted a unilateral change, in violation of HEERA, because the
University was not privileged to implement the policy before completing
negotiations over its effects. (Regents of the University of California (2021)
PERB Decision No. 2783-H.) The University had not met and conferred in good
faith before implementation of the policy.
Labor
leaders should demand to bargain over the impacts and effects of any
vaccination policy. And, if the failure to get vaccinated could lead to
discipline, the policy itself may be subject to decision bargaining. Employers
must provide notice and opportunity to meet and confer prior to mandating
vaccines. Employers can offer employees incentives to get vaccines, but it
cannot be so large that it is coercive.
Right to Refuse Vaccination
A. Food, Drug
& Cosmetic Act under the Emergency Use Authorization (EUA)
The
EUA requires employees be informed they have the right to refuse vaccination
and must be given a fact sheet listing the health consequences of refusal, and
of the alternatives to the product that are available and of their benefits and
risks, amongst other notices. However, the Acting Assistant Attorney
General Office of Legal Counsel (OLC) refused to read this language as
prohibiting public and private entities from requiring individuals to be
vaccinated.
On
July 6, 2021, the OLC issued a slip opinion addressing whether section 564 of
the Food, Drug and Cosmetic Act prohibits Entities from requiring the use of a
vaccine subject to and EUA. The slip opinion is not binding legal authority,
but delivers a strong opinion favoring mandatory vaccines. Ultimately, the OLC
concluded that section 564 does NOT prohibit public or private entities from
imposing vaccination requirements, even when the only vaccines are those
authorized under EUAs.
The
argument the vaccines are “experimental” because they only have emergency
authorization, and therefore cannot be mandated, is weak. EUA means the shot is
safe enough for the public. Further CDC has also said vaccines approved under
the EUA are “safe” an “effective.”
A
least one court has already rejected the claim “that the injection requirement
is forcing its employees to participate in a human trial because no
currently-available vaccine has been fully approved by the Food and Drug
Administration.” (Bridges v. Houston Methodist Hospital (S.D. Tex., June
12, 2021, No. CV H-21-1774) 2021 WL 2399994, at *2) The court explained “Equating the injection
requirement to medical experimentation in concentration camps is reprehensible.
Nazi doctors conducted medical experiments on victims that caused pain,
mutilation, permanent disability, and in many cases, death. … [employees] can
freely choose to accept or refuse a COVID-19 vaccine; however, if she refuses,
she will simply need to work somewhere else. … If a worker refuses an
assignment, changed office, earlier start time, or other directive, he may be
properly fired. Every employment includes limits on the worker's behavior in
exchange for his remuneration. That is all part of the bargain.” (Id.)
Moreover,
we expect the FDA to issue full approval in the coming months. Therefore, this
basis for an exemption is not likely to prevail. (See Legaretta v. Macias,
No. 21-CV-179 MV/GBW, 2021 WL 833390, at *1 (D.N.M. Mar. 4, 2021);
Bridges v. Houston Methodist Hosp., No. 4:21-cv-01774, 2021 WL 2399994, at
*1–2 (S.D. Tex. June 12, 2021.)
B.
Medical Accommodations under the ADA/ FEHA
An
individual that suffers adverse medical consequences—such as an allergic
reaction—to vaccinations may be entitled to a reasonable accommodation under
the Americans with Disabilities Act (“ADA”) (42 U.S.C. § 12101 et seq.)
and the California Fair Employment and Housing Act (“FEHA”) (Gov. Code §
12900 et seq.)
The
ADA and FEHA require that employers to provide a reasonable accommodation for
an employee’s disability. Such disability may include an inability to be
vaccinated due to a serious medical condition. The employee must first put
their employer on notice and request accommodation to begin an interactive
process. In addition, employees must put forward medical documentation to
substantiate their claim of a disability.
Moderate reactions to vaccines are probably not legally
sufficient. For example, in Hustvet v. Allina Health System (8th Cir.
2018) 910 F.3d 399, 411, the Eighth Circuit affirmed a judgment against an
employee who had “never been hospitalized due to an allergic or chemical reaction
[from a vaccine], never seen an allergy specialist, . . . [or] ever sought any
significant medical attention when experiencing a chemical sensitivity, taken
prescription medication because of a serious reaction, or had to leave work
early because of a reaction.” Therefore,
this claim will only be available to individuals who suffer serious, documented
medical consequences from being vaccinated.
C.
Religious Accommodations Under Title VII
Individuals
with sincerely held religious objections to the COVID-19 vaccine may also seek
a religious accommodation to a vaccination requirement under Title VII of the
Civil Rights Act of 1964 (“Title VII”). Title VII prohibits employers from
discriminating “against any individual with respect to his compensation, terms,
conditions, or privileges of employment, because of such individual’s . . .
religion.” (42 U.S.C. § 2000e-2(a)(1).)
An
employer must make reasonable accommodations for employees sincerely held
religious beliefs “unless an employer demonstrates that he is unable to
reasonably accommodate… without undue hardship on the conduct of the
employer’s business.” (42 U.S.C. § 2000e(j).) Thus, an employer is obligated to
try to reasonably accommodate an employee’s religious beliefs to the extent it
does not cause an undue hardship on the business, and failure to do so violates
Title VII. This does not mean that the employer is required to offer an
employee his or her preferred accommodation. Rather, the accommodation offered
simply must be reasonable. (Bruff v. N. Miss. Health Servs., Inc. (5th
Cir. 2001) 244 F.3d 495, 501.)
In
conclusion, public employers will generally be able
to mandate that employees receive vaccinations if they deem it necessary for
public health and safety. Individuals for whom vaccination poses a serious
health risk should be able to obtain an exemption under the ADA/FEHA. Further,
individuals that hold sincere religious objections to vaccinations may be able
to obtain a reasonable accommodation from their departments. Lastly, at a
minimum, the impacts and effects of such policies are subject to bargaining,
including the consequences of refusal.