Following the U.S. Supreme Court’s rejection of challenges to the Centers for Medicare & Medicaid’s mandatory COVID-19 vaccination requirements for certain health care workers, many of those employers have received requests for exemptions from the requirements based on their employees’ religious beliefs. While the majority of these requests are limited to the vaccination itself, we have encountered situations where the employee also voices religious objections to alternative protective measures, including masking and testing.

These employees cite a number of bases for these objections, including their view of masks as the “mark of the beast,” and potential contact with certain chemicals used in COVID-19 testing as incompatible with their views on bodily purity. How should health care and other employers respond in situations where the employee seeks exemption from most measures recommended for prevention of workplace spread of the COVID-19 virus?

Employers should use the same analysis put into place for the vaccination exemption requests. The employer may ask the employee to explain the basis for religious objections to these measures. If the objections are based on political or other non-religious reasons, the employer can deny them. In general, employers are hesitant about evaluating the sincerity of an employee’s professed religious beliefs. However, the religious exemption determination is not limited to this evaluation of the reasons for the request.

Employers can deny requested religious accommodation requests if they present more than a de minimus burden. This burden could be an undue hardship placed on the employer, or a direct threat to the employee, co-workers or third parties Health care employees providing clinical services to patients generally cannot maintain physical distancing. Those patients may not be vaccinated, and may have comorbidities that expose them to particular risk of serious illness or death from COVID-19 infections. Co-workers exposed to COVID-19 may miss work, putting the employer in a difficult position in terms of consistent staffing.

Health care and other employers may be able to establish more than de minimus hardships imposed by employees who object to effective protections against the COVID-19 virus, especially in the context of the Omicron variant surge. Any denial of a requested religious exemption should be accompanied by documentation of the anticipated burdens imposed, and the ineffectiveness of alternative measures considered.