Nurses are one of the first in line to get the new COVID-19 vaccines. However, due to the rapid pace with which the vaccines were made and authorized, plus the highly politicized atmosphere that surrounded their development, some nurses may be hesitant to get the shot, at least at first.

Although the situation and related policies are often changing as our understanding of the coronavirus and the vaccines grow, nurses may wonder if they’ll be required to get the COVID-19 vaccine. Is there a way to opt-out or delay the vaccination? What happens if they refuse?

The COVID-19 vaccine is still new and in limited supply, and because of that, there aren’t any current state or federal laws that require nurses to get the vaccine. Many facilities may also be waiting until the vaccine is more accessible before setting their own requirements.

With that in mind, the health care field does have experience with requiring vaccines. Based on that history, here’s what we can assume about whether or not nurses will be required to get the COVID-19 vaccine.

Mandatory Vaccine Policies

To get an idea of whether or not nurses will be required to get the new vaccines, we can look at the current mandatory vaccine policies for flu shots and other vaccines that federal organizations, states, and many facilities follow.

Facility Policies

The first policies to look at are at the facility level. Nurses who are curious about whether or not they’ll be required to get the vaccine should check with their facility management.

However, many facilities may still be waiting to hash out their policies on requiring the COVID-19 vaccine until more doses become available. Most likely, they’ll base their policies on long-standing vaccine requirements that they already have in place for other vaccines, like the flu shot.

Those policies generally require all patient-facing health care staff to show proof they’ve gotten the flu vaccine or to get proof of a legal exemption. If a worker doesn’t get the flu vaccine, they may be required to take extra precautions when at work.

Employers are within their rights to require employees to get vaccinated. However, just as with flu shot mandates, there will likely be room for exceptions based on state and federal policies.

State Policies

There are 18 states that currently require workers to get a flu shot or facilities to document an employee’s vaccinations: California, Colorado, Georgia, Illinois, Maine, Maryland, Massachusetts, Nebraska, New Hampshire, Nevada, New York, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, and Utah. 

The exact requirements and consequences for not getting the flu shot differ by state, but each state law can allow for exemptions based on religious, philosophical, or medical reasons.

This same policy may likely be applied to the COVID-19 vaccines. Over the next year, we’ll likely see some states enact new vaccination laws concerning COVID-19. Health care facilities will likely be required to document whether or not each employee receives the COVID-19 vaccine, and the laws will outline what exemptions are allowed and how facilities should document employee refusals. 

Federal Policies

Requirements for the COVID-19 vaccine may also come through at a federal level. Medicare and Medicaid might add it as a regulatory requirement for any facility that receives funding. 

On the other end, federal laws may protect employees who decline to get a required vaccination due to medical or religious reasons. 

We still aren’t sure how long immunity lasts after you get the COVID-19 vaccine, but if it lasts for about a year, then you might see recommendations from professional organizations and the U.S. Centers for Disease Control and Prevention to get the vaccine every year. 

If a year’s worth of immunity ends up being the case, then it’s likely that COVID-19 vaccines will be added to already-existing mandatory vaccine policies to prevent a surge of new cases once immunity wears off. In that case, exemption policies that apply to flu shots and other vaccines will likely apply to these new vaccines.

What Are Nurse’s Rights?

Mandatory vaccine policies for nurses will likely follow the same policies as for flu shots and other vaccines.

For health care workers, mandatory vaccine requirements date back as far as 1905 and the smallpox epidemic. In order to protect patients and fellow employees, health care professionals have been routinely required to get vaccinated with only a few exceptions for medical contraindications or religious beliefs. 

Many employees are also employed in states that have employment-at-will clauses, meaning employers can terminate an employee at any time and for any reason that isn’t federally protected by law, like disability or religion.

So the short answer to the question of if nurses will be required to get the COVID-19 vaccine is a complicated one — it depends. Facility, state, and federal mandates requiring nurses to get the vaccine may go into effect in the next few months or over the next year. 

Employers can legally require nurses to get the vaccine and enforce consequences for declining the vaccine. But nurses may have access to state or federal protections if getting vaccinated goes against medical advice or religious beliefs.

However, with vaccine doses still far and few between for a while, nurses who are wary of getting the vaccine early may be spared worrying over being required to get the vaccine right now. 

But as many parts of the health care world have changed repeatedly over the pandemic, nurses will need to keep in touch with their supervisors and pay attention to their facility’s policies to know for sure if they’ll be required to get the COVID-19 vaccine and what happens if they don’t.