Health care employees are at high risk for influenza exposure and can be source of the fatal disease because of their job. Numerous medical organizations support mandatory influenza vaccination for health care workers. The medical evidence in this record demonstrates that the single most effective way to prevent the transmission of influenza is vaccination. In the same vein, the Department requires all licensed state hospitals to provide the influenza vaccine to their employees at no cost and to report their compliance.

[Footnote: The Court is aware that [the Massachusetts regulation] provides that a hospital “shall not require an employee to receive an influenza vaccine … if: (a) the vaccine is medically contraindicated, which means that administration of influenza vaccine to that individual would likely be detrimental to the individual’s health; (b) vaccination is against the individual’s religious beliefs; or (c) the individual declines the vaccine.” Robinson does not assert a claim based on [the regulation] and the regulation does not affect the Court’s analysis of the Hospital’s Title VII liability. As discussed above, Title VII protects an employee from religious discrimination but permits an employer’s policy if the employer offers a reasonable accommodation or demonstrates that such accommodation would create an undue hardship.]

Here, in light of the state’s requirements and the Hospital’s understanding of the medical consensus on influenza vaccination, the Hospital decided to achieve the safest possible environment for its patients. With the exception of those with medical issues, the Hospital sought as close to total compliance as possible by requiring all persons who work in or access patient-care areas to be vaccinated. Robinson worked in a patient-care area. She worked closely with patients, regularly sitting near or touching them as she worked on their admission to the Hospital.

Had the Hospital permitted her to forgo the vaccine but keep her patient-care job, the Hospital could have put the health of vulnerable patients at risk. To allow Robinson to avoid relatively more vulnerable patients and not others would have been unworkable as well. It would have forced the Hospital to arrange its work flow around uncertain factors. On this record, accommodating Robinson’s desire to be vaccine-free in her role would have been an undue hardship because it would have imposed more than a de minimis cost.