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Vaccine Mandates in the Health Care Workplace

A Legal Analysis for Employers

Vaccine Mandates Cover ImageAn indispensable examination of laws related to vaccine mandates, providing guidance to health care employers, stakeholders, and the attorneys and staff who advise them. This instant PDF download is for anyone grappling with the right of health care employers to mandate COVID-19 vaccination of their workers.

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Analysis Includes

  • Practical checklists on vaccine mandate policy considerations and key issues for organization decision-making
  • Employers’ authority to mandate vaccination as well as health and safety obligations
  • Preparing for potential COVID-19 liability and lawsuits
  • Reasonable accommodation issues such as disability and religion
  • Overcoming employees’ vaccination hesitancy
  • Federal law and guidance from agencies overseeing employers’ legal rights and responsibilities regarding employee vaccination, including the Occupational Safety and Health Administration (OSHA), the Centers for Disease Control and Prevention (CDC), the Equal Employment Opportunity Commission (EEOC), and the Food and Drug Administration (FDA)
  • Future trends and recommendations

Factors Employers Should Consider—A Conversation with the Author

Brian Dean Abramson, author of Vaccine, Vaccination, and Immunization Law, speaks to Denise M. Hill, Associate Professor of Practice in Public Administration at Drake University and author of Vaccine Mandates in the Health Care Workplace: A Legal Analysis for Employers, about the factors employers should consider when deciding whether to implement vaccine mandates at their workplaces. They discuss how to structure a vaccine mandate that accounts for employees who don’t want to be vaccinated, the impact of recent case law and state actions, and ways to engage with vaccine hesitancy.

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Table of Contents

Executive Summary

  1. Introduction
  2. Overview of Key Legal Issues
    • Constitutional Authority for Public Vaccine Mandates
    • Public Vaccination Orders During an Outbreak
    • Balancing Scientific and Constitutional Factors
    • School Vaccine Mandates
    • Legal Authority for Mandatory COVID-19 Public Health Measures
    • Constitutional Challenges to COVID-19 Orders
    • The Role of Vaccination in Meeting Organizations’ Health and Safety Obligations
    • Duty to Provide a Safe and Healthy Workplace
    • Mandatory Vaccination of Health Care Personnel
    • Employers’ Authority to Mandate Vaccination
    • Employer Discretion Re: Terms and Conditions of Work
    • Federal Law and Guidance
    • OSHA and Employer COVID-19 Vaccination Requirements
    • OSHA COVID-19 Guidance
    • CDC and Employer COVID-19 Vaccination Requirements
    • EEOC and Employer COVID-19 Vaccination Requirements
    • Vaccine Exemptions Based on Disability
    • Vaccine Exemptions Based on Religion
    • Reasonable Accommodations for Vaccine Mandates
    • FDA and Employer COVID-19 Mandates
    • FDA Emergency Use Authorization and COVID-19
    • Analysis of Employer COVID-19 Vaccine Mandate Issues
    • State Vaccination Laws
    • State Laws and Bills Banning Vaccine Mandates
    • COVID-19 Employer Liability and Lawsuits
  3. The Current Environment
    • Impacts of COVID-19, the Ongoing Pandemic and Uncertainty
    • Vaccine Hesitancy
    • Reasons for Vaccine Hesitancy
    • Reasons for COVID-19 Vaccine Hesitancy
    • Mixed Messages
    • Politicization of Public Health and Conspiracy Movements
    • Prior Negative Experiences and Legacy of Public Mistrust
    • Swine Flu Mass Vaccination
    • Smallpox Vaccination (2003)
    • The Pharmacuetical Industry
  4. Trends for the Immediate Future and Recommendations to Clients
    • Short Term COVID-19 Trends
    • Legal and Regulatory Trends
    • FDA
    • OSHA
    • EEOC
    • CMS
    • Unions and the NLRB
    • The Importance of Practical Long-Term Vaccine Policy Thinking and Planning
    • Recommendations to Clients Regarding Vaccine Initiatives
    • Employers Can Change Course on Vaccination Mandates
  5. Practice Tips and Tools
    • COVID-19 Vaccine Health Care Organization Decision Making Checklist
    • COVID-19 Vaccine Mandate Policy Considerations


Denise M. Hill, has over 25 years of legal, policy, and mediation experience. She is a fulltime Associate Professor of Practice in Public Administration at Drake University and continues to practice health and employment law with the Whitfield & Eddy law firm in Des Moines, Iowa. Previously, Denise was the Director of Health Law Programs at Drake Law School; was an Associate Professor in the Colleges of Medicine, Podiatry, and Health Sciences at Des Moines University; and also taught for the University of Iowa’s Executive MHA program. In addition to her work in private practice and academia, Denise was an Attorney/Manager of Public & Regulatory Affairs with the Iowa Medical Society and a State of Iowa labor relations attorney.

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