Can My Employer Terminate Me for Not Taking the Flu Vaccine?

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In April of this year, a California Court of Appeal provided guidance for healthcare employers who had or continue to have vaccination mandates. In Hodges v. Cedars-Sinai Medical Center (“Hodges”), the Court of Appeal ruled that a hospital’s decision to terminate an employee for failing to comply with its flu vaccination mandate did not violate California’s Fair Employment and Housing Act (“FEHA”) prohibition on disability discrimination.

Facts in Hodges

Plaintiff Deanne Hodges was employed by Cedars-Sinai Medical Center (“Cedars”), a non-profit academic health center in Los Angeles. She started working for Cedars in 2000 in an administrative role with no patient care responsibilities. In 2007, she was diagnosed with stage III colorectal cancer and temporarily stopped working to receive treatment. She returned to work in 2009.

Since she had no direct patient contact, Ms. Hodges was under no obligation to get a flu vaccine when she was hired or when she returned from cancer treatment. However, this changed in 2017 when Cedars changed its policy requiring all employees, as a condition of their continued employment and irrespective of their role, to be vaccinated by the beginning of the flu season. The 2017 policy aligned with recommendations from the United States Department of Health and Human Services Centers for Disease Control and Prevention (“CDC”) and made exceptions for employees with “a valid medical or religious exemption.” Employees who declined to get the vaccine for medical reasons were required to submit a completed exemption request form from their physician for review by Cedars’ internal review panel.

Ms. Hodges obtained a note from her doctor recommending an exemption based on her history of cancer and resulting allergies, her “extreme unwell state” resulting from injections and other vaccinations, and her lack of patient contact. Cedars denied her exemption request and asked her to reconsider her decision not to get the vaccination. Ms. Hodges refused and was terminated.

Ms. Hodges sued Cedars for several causes of action under FEHA, including disability discrimination, failure to engage in the interactive process, and failure to accommodate a disability. Cedars moved for, and was granted, full summary judgment by the trial court.

The Court of Appeal’s Decision

The Court of Appeal affirmed the trial court’s grant of summary judgment. In doing so, the Court of Appeal had to grapple with questions regarding the legal standard for Ms. Hodges’ claims.

Ms. Hodges argued that the McDonnell Douglas burden-shifting test (a test used to determine whether an employee was discriminated at work) should not apply when there is so-called “direct evidence” that the employer’s challenged conduct was motivated by prohibited reasons. While the Court of Appeal agreed in principle that the McDonnell Douglas test does not apply in the face of direct evidence, the Court ruled that Ms. Hodges did not present any direct evidence of discrimination.

While the Court held that Ms. Hodges’ history of cancer was a physical condition, it did not technically constitute a “physical disability” under FEHA because it did not “limit a major life activity.” In fact, Ms. Hodges herself conceded that her medical condition did not limit her ability to perform major life activities (including work).

The Court of Appeal also found that Cedars’ decision to terminate Hodges was legitimate and non-discriminatory, particularly because Cedars’ policy for medical exemptions aligned with CDC recommendations.

Significance of Hodges for Employers

The decision provides guidance on how courts may analyze vaccination requirements in the workplace. Here are the key takeaways:

  1. An employee’s concession that a physical condition does not interfere with major life activities may undermine their discrimination claim.
  2. An employer may rely upon CDC guidance and recommendations to help ensure the enforceability of its vaccination policy, so long as it is applied consistently and objectively.
  3. Courts may be more deferential to employers in healthcare settings.
  4. A minor reaction to a vaccine may not amount to a “disability”.
  5. An employer is not bound to accept an employee’s subjective belief that he or she is disabled.
  6. Vaccination mandates may be enforced on employees who have no direct contact with patients (e.g., employees in administrative roles).
  7. Vaccination mandates must comply with FEHA. This includes reasonably accommodating employees and applicants with disabilities or religious beliefs.

For more information on disability discrimination under California’s Fair Employment and Housing Act, please contact us at

This material is provided for informational purposes only. It is not intended to constitute legal advice, nor does it create a client-lawyer relationship between MNK Law and any recipient. Recipients should consult with counsel before taking any actions based on the information contained within this material.