On December 16, 2020, the EEOC updated its What You Should Know About Covid-19 and the ADA, the Rehabilitation Act, and Other EEO Laws to address COVID-19 vaccinations. The update confirms that employers may require approved COVID-19 vaccinations when they are available, but they must do so in compliance with EEO laws. Given the uncertain landscape created by the COVID-19 pandemic, the new guidance also specifies that EEO laws will not prevent employers from following applicable guidelines from the CDC or other federal, state, and local public health authorities.

Key take-aways from the EEOC’s updated guidance include the following:

• A COVID-19 vaccination is not a “medical examination,” nor does it implicate Title II of the Genetic Information Nondiscrimination Act (GINA). (K.1, K.8) The administration of an FDA approved or authorized COVID-19 vaccine by an employer or a third-party contractor does not constitute a “medical examination” for purposes of the ADA. Administering the vaccine likewise does not implicate GINA because it does not involve the use, acquisition, or disclosure of “genetic information” under the statute.
• Pre-vaccination medical screening questions may be “disability-related” inquiries under the ADA and could implicate GINA. (K.2, K.9) Pre-vaccination screening questions recommended by the CDC are likely to elicit information about a disability. Therefore, if an employer requires employees to receive vaccinations and administers them itself (or contracts directly with a third party to do so), it must show that pre-screening questions are “job-related and consistent with business necessity.” If an employer is administering vaccines itself, pre-vaccination questions that address or elicit genetic information could also implicate GINA.
• Employers can provide COVID-19 vaccinations (including pre-screening questions) without meeting the ADA “job related/business necessity” standard or implicating GINA under certain circumstances. (K.2) Employers can provide vaccinations while avoiding the legal challenges involved in pre-vaccination screening questions in at least two ways:
  1. the employer can offer vaccinations to employees on a voluntary basis (where answering pre-screening questions is also voluntary, and questions do not seek genetic information); or
  2. the employer can arrange to have vaccinations administered by a third party with whom it does not have a direct contract (i.e., a pharmacy or other outside health care provider).
• Rather than administer COVID-19 vaccinations, employers can simply recommend employees get the vaccine and then request or require proof that an employee received a COVID-19 vaccination. (K.3) An employer who requests or requires proof of a COVID-19 vaccination is not likely to elicit information about a disability, and the request therefore is not a prohibited “disability-related” inquiry under the ADA. However, the employer should avoid any follow-up questions and caution employees against providing any medical information beyond proof of vaccination.
• Employers should assess whether an employee with a disability who cannot take a required COVID-19 vaccine poses a direct threat at the worksite. (K.5, K.7) If an employee cannot receive a required COVID-19 vaccine due to a disability, the employer must assess whether that unvaccinated employee poses a “direct threat” at the worksite under the ADA. That assessment must consider four factors:
  1. the duration of the risk;
  2. the nature and severity of the potential harm;
  3. the likelihood that the potential harm will occur; and
  4. the imminence of the potential harm.
• If an unvaccinated employee with a disability poses a direct threat, the employer must then explore whether reasonable accommodations could eliminate or reduce that threat. (K.5) Employers can rely on CDC recommendations and OSHA guidance to assess potential accommodations. If the direct threat cannot be reduced to an acceptable level, the employer can prohibit the employee from physically entering the worksite. However, the employer may not automatically terminate that employee. Rather, the employer should consider remote work or other off-site arrangements for the unvaccinated employee.
• Employers must try to accommodate employees who cannot take a required COVID-19 vaccine because of a sincerely held religious belief. (K.6, K.7) If an employer learns that an employee’s religious beliefs prevent them from taking a required COVID-19 vaccine, it must attempt to accommodate that employee if it can do so without undue hardship. If there is no reasonable accommodation possible, the employer may exclude the unvaccinated employee from the worksite. Again, however, this does not mean that the employer may automatically terminate that employee. Rather, the employer should explore other work arrangements and the implications of other federal, state and local EEO laws.

Based upon current EEOC guidance, employers in most industries can alleviate administrative burdens, minimize legal exposure, and best achieve a vaccinated workforce by strongly recommending that employees obtain a COVID-19 vaccine or by providing vaccinations administered by an unrelated third-party healthcare provider. Employers can also lawfully request or require proof of vaccination without collecting any other private health information about their employees.

For additional and information and discussion of COVID-19 vaccinations and what they mean for employers, please see Lake Effect’s prior blog on vaccines.  We will continue to closely monitor all developments in this area and provide you with important updates.

On December 10, 2020, a Food and Drug Administration (FDA) advisory committee will meet to review Pfizer’s COVID-19 vaccine and recommend whether to authorize its emergency use in the United States. Moderna is also seeking FDA Emergency Use Authorization (EUA) for its COVID-19 vaccine, and dozens of other pharmaceutical companies are in the process of developing and seeking approval for vaccines. As the country awaits word on FDA authorizations, governmental bodies and other organizations are preparing for the complexities involved in distributing a COVID-19 vaccine and prioritizing who will receive the first doses.

No doubt, many employers welcome the prospect of a safe and effective COVID-19 vaccine in hopes that remote employees can return to the workplace and safely resume serving clients, customers, and partners. However, this scenario assumes that most employees will get a COVID-19 vaccine when it becomes available. It also raises a difficult question: Can an employer require employees to get a COVID-19 vaccine as a condition of continued employment?

Current FDA guidance:
Federal and state authorities have not directly answered this question. A member of the FDA advisory panel recently stated that vaccines authorized under the FDA’s EUA (as opposed to through the normal approval process) cannot be mandated. This is consistent with 2017 FDA guidance stating that recipients of EUA products must be informed that they have the option to accept or refuse the product and what the consequences of refusal may be. However, there is some dispute as to whether the FDA’s prior position on this issue would control if the Secretary of Health and Human Services adopts a contrary position as to EUA COVID-19 vaccines.

Current EEOC guidance:
Even if initially authorized under an EUA, COVID-19 vaccines will likely be approved through the FDA’s normal approval process in the near future. Employers will then face the same question: can they require employee vaccinations? Current EEOC guidance on Pandemic Preparedness in the Workplace and the Americans with Disabilities Act, updated in March 2020, considers the issue in the context of the influenza vaccine (specifically recognizing that there was no vaccine for COVID-19 at that time). In the case of the influenza vaccine, the EEOC guidance states that “employers should consider simply encouraging employees to get the [vaccine] rather than requiring them to take it.”

Required accommodations:
However, the EEOC guidance also suggests that a mandatory vaccination requirement (influenza, COVID-19, or otherwise) for all employees is permissible as long as employers make exceptions in two instances:

1. to provide a reasonable accommodation to an employee with an ADA-covered disability that prevents them from taking a vaccine; and
2. to provide a reasonable accommodation to an employee with a sincerely held religious belief, practice, or observance that prevents them from taking the vaccine, as required under Title VII.

Presumably, reasonable accommodations in lieu of a mandatory COVID-19 vaccine could include permitting telework, increased use of PPE for the employee and co-workers, modification of job duties (i.e., removing public interactions), or transfer to a different office space. In any case, providing an employee accommodation must not cause an undue hardship to the employer. Because COVID-19 is so easily transmitted, and because the EEOC recognizes it as a pandemic and a “direct threat” to employee safety under the ADA (as does OSHA), employers might be granted greater latitude in difficult accommodation cases.

Other considerations:

Although a mandatory COVID-19 vaccination policy may be permissible under current law, this should not end the inquiry for employers seeking to maximize their workforce potential during these challenging times. Beyond its legality, an employer should determine whether implementing a mandatory vaccination policy is necessary or even advisable based upon the nature, needs, and unique culture of its organization. Relevant considerations may include:

• The frequency and duration of employee interactions with vulnerable populations and/or members of the general public (how critical are employee inoculations to the survival and success of the business?)
• Cost(s) associated with a mandatory employee vaccination policy/program (time, expense, goodwill of the public and employees)
• The impact of existing policies, collective bargaining agreements, or past practices on the introduction of a mandatory vaccination policy
• The potential impact of a mandatory vaccination policy on workplace injury and safety claims
• The logistics required to administer a mandatory vaccination policy/program on or off-site (including necessary forms, a clear process for requesting accommodations, and protocols for retaining confidential vaccination information; staggering vaccinations may also be required as potential side-effects could render employees unable to work for several days)
• The availability, cost, and efficacy of other mitigation measures used to prevent the spread of COVID-19 (including an assessment of the measures used to date)
• Alternative ways to encourage and incentivize employees to voluntarily get the COVID-19 vaccine (i.e., rewarding employees who get the vaccine with added benefits under a wellness program)

Employers should also consider conducting surveys to gather employee feedback before formulating a COVID-19 vaccination policy. Some employees may have specific safety concerns about the FDA’s approval process for new COVID-19 vaccines. Other employees may be skeptical about the medical community or generally concerned about vaccines based upon historical events or personal experiences. Inviting employees to express opinions and concerns can build trust and enhance employee morale. It can also inform an employer’s decision-making and communication strategy as it prepares to welcome more employees back to the workplace, regardless of whether or not an employer adopts any COVID-19 vaccination policy. If an employer decides to proceed with a mandatory vaccine policy, communicating with employees and other stakeholders about the underlying rationale and implementation would be a critical next step.

Stay tuned:
Given the current legal landscape, employers can begin planning the most effective ways to protect their employees and the general public when a COVID-19 vaccine becomes widely available. However, it is entirely possible that we will see new guidance on mandatory vaccinations from federal and/or state authorities after the FDA completes its authorization process.

Lake Effect will continue to closely monitor all developments in this area and provide you with important updates.

Lake Effect is here to answer your questions about protecting your workforce and business consistent with state and federal law. We continue to monitor important legal and HR developments, including COVID-related updates from federal, state, and local authorities. Please keep watching our blogs and emails for these important updates, as well as discussions of how compliance meets culture. To dive into these issues, contact us at info@le-hrlaw.com or 1-844-333-5253.