Some people may be at risk of an adverse reaction due to an allergy to one of the components of the vaccine or a medical condition. Some people may refuse vaccination because of sincere religious belief. With COVID-19 vaccines, this means that the employee must provide medical evidence to need an exemption. However, the laws of Alabama and Iowa eliminate the requirement for medical evidence, directly putting them at odds with the ADA and federal law.
Last year, we tried different approaches to increase vaccination rates against COVID-19, with the goal of reducing the spread of variants and preserving hospital capacity. For example, officials launched incentive programs, emphasized personal responsibility, and deployed mobile vaccination units to encourage the acceptance of vaccines. As we detailed above, many federal, state and local officials ultimately demanded that certain types of workers receive the COVID-19 vaccine. Keep up to date with the latest information on COVID-19, including advances in vaccine efficacy and availability, new variants, and more, by visiting the AAFP COVID-19 Vaccine Center.
CMS requires that all healthcare workers be fully vaccinated against COVID-19 at facilities that participate in Medicare and Medicaid. Section 381.00317 prohibits COVID-19 vaccination mandates from private employers, unless the employer provides employees with certain individual exemptions from the vaccination requirement. Greg Abbott issued an executive order prohibiting all employers in that state from seeking vaccination against COVID-19, and the Tennessee legislature has just passed a measure that seeks to achieve the same result by prohibiting employers from asking employees if they have been vaccinated. This decision establishes a uniform COVID-19 vaccination standard for workers at facilities that participate in Medicare and Medicaid.
As described in the immunization exemption policy, with the exception of policies that allow rejection due to a documented allergy or medical contraindication, the AAFP does not support immunization exemption policies. The Florida State Department of Health has enacted forms for employees to use with respect to exemptions. The AAFP has reviewed and approved all CDC ACIP recommendations related to COVID-19 vaccines. More information is described in the CMS Interim Provisional Final Immunization Rule for Omnibus COVID-19 health personnel.
As COVID-19 vaccination mandates proliferate across the country, so does the rejection of them by those who don't want to receive the vaccine. While many employees seek exemptions on religious grounds, others argue that they have medical reasons to evade mandates. Private employers are prohibited from imposing COVID-19 vaccines on employees without the opportunity for employees to obtain an exemption. But as the rejection of vaccines continues, so does the pressure, largely driven by political motives, to expand employees' ability to apply for a medical exemption.
CDC, AAFP, ACOG, and others strongly recommend that people who are pregnant or breastfeeding get vaccinated against COVID-19.