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In a directive that could have wider implications, the VA has defined procedures for employees covered by its partial Coronavirus vaccination mandate — essentially, “Title 38” employees involved with direct patient care — to request exceptions from that requirement.

Because the policies are grounded in law applying government-wide, similar considerations could apply to any other agencies that impose mandates. No other agencies have followed suit since the VA last week announced its partial mandate, but the justification behind the VA policy could apply as well to health care employees of other agencies.


Further, the general policy announced last week of giving federal employees the choice of being vaccinated or being subject to frequent testing and other stricter safety protocols also allows for exceptions on the same two grounds listed in the VA directive: medical conditions or religious beliefs.

The VA directive says that employees seeking a medical exemption would have to sign a form and have a physician’s signature stating that they fall under the CDC’s medical “contraindications” or precautions regarding the vaccines.

The “contraindications” are “severe allergic reaction (e.g., anaphylaxis) after a previous dose or to component of the COVID-19 vaccine; and immediate (within 4 hours of exposure) allergic reaction of any severity to a previous dose or known (diagnosed) allergy to a component of the vaccine.”

Precautions apply to “immediate allergic reaction to any other vaccine or injectable therapy (i.e., intramuscular, intravenous, or subcutaneous vaccines or therapies [excluding subcutaneous immunotherapy for allergies, i.e., “allergy shots”]).”

The CDC also recommends delaying vaccination in certain situations, including for persons with current cases of COVID-19.

The second potential ground for exemption, a “deeply held religious belief” is not defined in detail. Under general EEOC policies, an employer “should ordinarily assume that an employee’s request for religious accommodation is based on a sincerely held religious belief, practice, or observance.” However, an employer “would be justified in requesting additional supporting information” if it “is aware of facts that provide an objective basis for questioning either the religious nature or the sincerity of those beliefs.”

Under EEOC policy an employer must make a “reasonable accommodation” to an employee qualifying for an exception on either medical or religious grounds unless doing so would create an “undue hardship” for the employer.


The VA directive states that employees who qualify for an exception and other unvaccinated employees must wear a mask while onsite regardless of what duties they are performing apart from limited situations such as when working alone in an enclosed office. Guidance on the new general policy meanwhile says that for the “vast majority” of employees who would qualify for an exception, following the stricter policies applying to unvaccinated persons would suffice as an accommodation.

The VA has said that employees who do not comply with its mandate could face disciplinary action up to and including firing, with normal procedures to be followed.

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2022 Federal Employees Handbook