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term health effects such as infertil- ity — or perhaps they've already been diagnosed with COVID-19 and want to save doses for individ- uals who need them. They can also object to vaccina- tion because of religious beliefs. You generally shouldn't question the validity of claims of a reli- gious objection. You can, however, ask for more information about their beliefs if you legitimately question the sincerity of the objection. Employees might also not be able to receive a vaccination because of a health disability. At least one federal anti-discrimination law that sometimes limits employers' rights and ability to act on their employees' work statuses because of health issues doesn't apply here, however. The EEOC has said that GINA, which forbids you from making employ- ment decisions based on employees' medical histo- ries, isn't triggered by requiring a COVID-19 vaccine. How should you handle vaccine objectors? You essentially have two choices to make when faced with employees who don't get vaccinated for personal reasons. If you feel an unvaccinated employee poses no serious health risk to patients or coworkers, you can allow them to work while undergoing daily screenings for COVID symptoms, wearing PPE, engaging in proper infection control practices and following social distancing guide- lines. If, however, you determine an employee poses a direct threat to others, including patients, that employee can be barred from entering your facility. When access becomes a matter of dispute, utilize the existing regulations that apply to employees who have received COVID-19 diagnoses or are symptomatic. In the healthcare context, you have broad lati- tude because most jobs include direct patient care. In many cases, employees who insist on trying to come to work with COVID symptoms, or without a vaccination, can be terminated. Not getting vacci- nated is ultimately the employee's choice — but it can cost them their job. Employees who will not be vaccinated can be rightfully terminated if you feel they directly threaten the health and well-being of your patients. What about employees who refuse for religious or health reasons? You can offer accommodations for employees who object to getting vaccinated due to their religion or disability. These accommodations can include allow- ing them to take a medical leave of absence or offer- ing them a position they could perform from home so patients or coworkers aren't potentially exposed to the virus. These accommodations must be made if they won't create an undue hardship on your facil- ity, which essentially means they'll result in a mini- mal financial cost or operational burden to you. Train your managers on how to recognize an accommodation request — and make the accommo- dation-offering process with your employees an interactive one. Meet with them. Tell them you understand their concerns. Share your concerns and explain why you're making them your offer. As always, document what each party says at any meeting that's held. Should your staff administer vaccines? Vaccinations received by your staff should be administered by a third party. That avoids trigger- ing ADA issues caused by asking for information about an employee's disabilities or GINA issues caused by asking for information about an employee's medical history. The COVID-19 vac- cines are available under special Emergency Use Authorizations (EUAs), which require recipients to receive information about the vaccine in advance. You should have access to these EUAs and provide them to employees who are interest- ed in receiving the vaccination. OSM Ms. Duhart (casey.duhart@wallerlaw.com) is an associate attorney at Waller, Lansden, Dortch & Davis in Nashville. F E B R U A R Y 2 0 2 1 • O U T P A T I E N T S U R G E R Y . N E T • 1 7 Not getting vaccinated is ultimately the employee's choice.