Health care providers want assurance that their employees neither pass on infections to patients nor become infected from them. These dual demands raise the issue of immunity testing and vaccinations for staff. Vaccinations have been a major public health and general public topic based on recent measles outbreaks. A health care provider has to address the fact that some employees may resist vaccinations on disability, religious, or other grounds. In this context, the court in Hustvet v. Allina Health Systems, 910 F.3d 399 (8th Cir. 2018), recently addressed whether an employee, terminated for refusing the measles, mumps, and rubella (“MMR”) vaccine, could prevail on an American with Disabilities Act (“ADA”) claim. Hustvet, an individual living skills specialist, refused the MMR vaccination, claiming allergies and chemical sensitivities. She further contended that her employer’s mandatory test for immunity to infectious diseases violated the ADA’s general ban on medical exams. Her employer, as recommended by the Centers for Disease Control, tested the class of employees who might come in contact with communicable diseases in their patient-facing work. The court’s decision noted that the ADA does not prohibit medical exams that are job-related and a business necessity, which the court found was true here because the employee would work with patients with communicable diseases or weak immune systems.

The key takeaway for health care employers is to determine, before requiring vaccinations and testing for immunity to infectious diseases, that the requirements are job-related and a business necessity, and thus permissible under the ADA.