The right to religious exemptions from vaccine mandates has proven a powerful legal tool amid rising vaccination requirements in workplaces, particularly hospitals, according to Andrew Schlafly in the spring issue of the Journal of American Physicians and Surgeons.
Schlafly, general counsel for the Association of American Physicians and Surgeons (AAPS), observes that despite ongoing debates about COVID-19 vaccines, mandates continue to expand not only for those shots but also for annual influenza vaccines across hospitals, schools, the military, and general employment.
Many hospitals now enforce mandatory annual flu shots for all staff, with limited tolerance for exemptions. In this environment, religious objections have emerged as the most effective legal basis for resisting such policies under Title VII of the Civil Rights Act, which requires employers to reasonably accommodate sincerely held religious beliefs unless doing so imposes an undue hardship.
Schlafly emphasized that when employers deny religious accommodations, employees often must pursue litigation or file complaints with the Equal Employment Opportunity Commission (EEOC) for religious discrimination. Knowledge of how to properly articulate and assert these objections can make a critical difference, especially in hospital settings where resistance to exemptions appears common.
The article centers on the case of Palms v. Texas Children’s Hospital, involving Tisha Palms, a radiographer with over 20 years of service at the hospital. In 2022, the hospital implemented a flu vaccine mandate. Palms had previously received annual flu shots voluntarily for many years but requested a religious exemption that year, citing sincerely held beliefs (including that her body is a temple and that God provides protection without vaccines, with her convictions evolving notably after reflection on COVID-19 and related vaccines).
The hospital initially granted her a religious exemption from the COVID-19 vaccine but denied the flu shot request. Officials cited inconsistency: her past acceptance of the flu vaccine suggested her current objections were not sincere or sufficiently explained. When Palms could not adequately detail the change in her beliefs to the hospital’s satisfaction, it moved toward suspension and potential termination.
Palms filed a federal lawsuit alleging Title VII religious discrimination and failure to accommodate. Shortly after the suit was filed, and just days into her suspension, the hospital reversed course, granted the exemption, and allowed her to continue working. The district court then dismissed the case on summary judgment, reasoning that the eventual accommodation mooted her claims. It also ordered Palms to pay some of the hospital’s costs and fees.
A divided Fifth Circuit panel initially affirmed the district court’s ruling in August 2025; however, after a petition for rehearing en banc was filed (with Schlafly involved in advocacy), the hospital opted to settle rather than face further proceedings.
Schlafly interprets the outcome as a practical victory for religious exemptions, demonstrating that persistence can compel employers to reconsider denials. He cautions that hospitals frequently show hostility toward religious objections to vaccination, underscoring the need for careful preparation of exemption claims and readiness to challenge adverse decisions through legal channels or EEOC filings.
“Persistence is necessary,” Schlafly concluded, urging affected workers to stand firm in defending their free exercise rights against expanding mandates.
