United States: The Dos And Don’ts Of Implementing A Mandatory Flu Vaccine Policy Outside The Hospital Setting

Last Updated: January 30 2013
Article by Meredith R. Murphy

As health experts describe this flu season as one reaching epidemic proportions, many employers are questioning the legality of requiring their employees to receive a flu vaccine shot when they recognize business and safety needs for ensuring their work environments and workforce are better protected from the flu virus.  This need is especially acute for non-hospital employers who care for individuals with compromised immune systems, such as rehabilitation centers or schools.  While a different set of considerations come into play when a hospital is assessing how to implement a flu vaccine policy (see our post from January 24, 2013 – " Firing Employees Who Don't Get Flu Shots:  What Risks Do Hospitals Face", Mark Nelson), non-hospital employers have business needs and health concerns that may make implementation of a flu vaccine policy desirable or necessary.

So, what should an employer consider before implementing such a policy?

  • DO evaluate the business need for the policy.  Whether it be concern for patients, clients, or customers or, rather, a need to ensure that your workforce is less likely to be on leave due to a flu outbreak, an employer must be prepared to identify its reasonable business interest if the policy is challenged.
  • DO consider what type of policy suits business needs.  Some employers are implementing mandatory policies for all employees to receive a flu shot.  Others are only requiring that certain categories of employees receive a flu shot, i.e., those with regular access to patients or individuals with compromised immune systems.  Still others are implementing a policy that "strongly encourages" flu vaccinations.
  • DO review any applicable Collective Bargaining Agreements.  Under the National Labor Relations Act, a flu vaccination policy is a mandatory subject of bargaining.  This means that a unionized employer cannot unilaterally implement such a policy without giving the union notice of the policy and bargain over the policy if the union requests.  However, as set forth under recent National Labor Relations Board caselaw, a union may waive a right to bargain over such a policy by way of a Management Rights Clause.  See Virginia Mason Medical Center, 358 NLRB No. 46 (2012).  If unionized, employers should evaluate the breadth of their clause to see if the union has waived the right to bargain regarding the employer's right to direct employees, to determine materials and equipment to be used and/or to implement improved operational methods and procedures.  In the Virginia Mason case, the NLRB specifically recognized this type of waiver language as permitting the Medical Center to require non-immunized nurses to wear facemasks.
  • DON'T refuse to engage in an interactive process with any objecting employees.  Employers should be prepared to work with an employee's health or religious objections to receiving a flu shot.  The Equal Employment Opportunity Commission has taken the position that employees may be exempt from a mandatory vaccination requirement based on an ADA disability or a "sincerely held religious belief, practice, or observance."  See www.eeoc.gov/facts/pandemic_flu.html -48k-2009-10-21.  Courts have recognized that such sincerely held" beliefs may include lifestyle choices such as veganism.  See Chenzira v. Cincinnati Children's Medical Center, No. 11-917 (S.D. Ohio, December 27, 2012).  In such instances where an employee expresses a health or religious-based objection to a mandatory flu vaccine policy, the employer should discuss reasonable accommodations with the employee, e.g., exempting the employee from the policy entirely, transferring the employee to another position temporarily (until the flu threat ends as determined by local health officials) or permitting the employee to wear a facemask when in proximity to patients and coworkers.
  • DON'T terminate any employee who refuses a flu shot without engaging in the interactive process if they are objecting for health or religious reasons.  Further, any disciplinary measures should be uniformly implemented in the case of employees in violation of the policy.  Employers may also want to consider progressive discipline for first-time offenders, e.g., issuing a warning letter for an initial failure to show proof of a flu shot or failure to wear a facemask.
  • DO ensure that any policy implemented is enforced uniformly.  Require proof that employees have received a flu shot.  In the case of objectors, seek a waiver that the employee is unable or objects to vaccination and then engage in the interactive process to agree upon a reasonable accommodation.
  • DO consider making flu shots available to employees on-site to maximize compliance with any flu shot policy.
  • DON'T implement a policy without contacting your state's Department of Health or any other related agencies.  These agencies can provide guidance on the manner in which vaccine policies should be implemented for various categories of employers or regarding possible accommodations for objecting employees.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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