The following is an edited copy of a page saved from the AMA web site in March 2002.

Since religious/philosophic exemptions from immunizations endanger not only the health of the unvaccinated individual, but also the health of those in his or her group and the community at large, the AMA
(1) encourages state medical associations to seek removal of such exemptions in statutes requiring mandatory immunizations;
(2) encourages physicians and state and local medical associations to work with public health officials to inform religious groups and others who object to immunizations of the benefits of vaccinations and the risk to their own health and that of the general public if they refuse to accept them; and
(3) encourages state and local medical associations to work with public health officials to develop contingency plans for controlling outbreaks in exempt populations and to intensify efforts to achieve high immunization rates in communities where groups having religious exemptions from immunizations reside. (CSA Rep. B, A-87; Reaffirmed: Sunset Report, I-97)

AMA's current article on this issue:
Why medical reasons should be the only exemptions from vaccinations

I am being asked to produce documentation of immunization for measles, mumps and rubella for a medical/surgical nursing job. My nurse colleagues and I have never heard of this required for employment to any hospital. Does an employer have a right to force an individual into getting an MMR vaccination for the sole purpose of employment? Look forward to your comments. Thanks.

Ann Kiernan replies:

If you were not a health care worker, the answer would certainly be NO! But since the nature of nursing involves occupational exposure to infectious diseases, the employer might be able to ask about your immunization status and perhaps even to require re-vaccination if you do not have proof of current protection.

Under the Americans with Disabilities Act (ADA), after an applicant is given a conditional job offer, but before s/he starts work, an employer may conduct medical examinations, regardless of whether they are related to the job, as long as it does so for all entering employees in the same job category. But, after employment begins, an employer may make disability-related inquiries and require medical examinations only if they are job-related and consistent with business necessity. Also, an employer may require employees to submit to medical examinations that are required by another federal law or regulation. 29 C.F.R. 1630.15(e)(1998) See: Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees Under the Americans with Disabilities Act (ADA).

So, is immunity to measles, mumps and rubella either "job-related and consistent with business necessity" or required by other law? Maybe, according to our research at the [Archived] Centers for Disease Control.

The CDC report strongly recommends that health care workers be immunized for hepatitis B, influenza, measles, mumps, rubella, varicella zoter, and tetanus.

Another federal agency, OSHA, says in its [Archived] Technical Manual governing hospitals [Chapter 1. IV B 2. b] that: "Vaccination for rubella, measles, mumps, and influenza is recommended, especially for women of child-bearing age."

[Note: [Chapter 1. III B 3.] also says, " A safety committee and/or infection control committee should be established within the hospital. Periodic inspection and monitoring is the responsibility of the safety committee. Immunizations, other than the mandatory vaccination for Hepatitis B, should be offered to personnel at risk."

It is not directly relevant to your situation, but a recent federal appeals decision upheld a Navy captain's right to insist that both military and civilian personnel on his ship be vaccinated for anthrax when they were entering " high threat areas and contiguous waters". Mazares v. Dep't of the Navy, 302 F.3d 1382 (Fed. Cir. 2002)

Thanks for raising such an interesting issue. We have only scratched the surface here. This would be a good question to pose to your state nursing society or professional board for a definitive answer.

Information here is correct at the time it is posted. Case decisions cited here may be reversed. Please do not rely on this information without consulting an attorney first. ----Disclaimer End----

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