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Federal and State COVID-19 Vaccine Mandates: Where Do They Stand?

Federal, state, and local authorities have proposed or adopted a growing number of COVID-19 vaccination mandates for employees. Here’s an overview of these requirements:

Federal Mandates:

In September, President Biden announced that the Department of Labor’s Occupational Safety and Health Administration (OSHA) is developing a rule that would require all employers with 100 or more employees to ensure their workers are fully vaccinated or produce a negative test result once a week prior to coming to work. OSHA intends to issue an Emergency Temporary Standard (ETS) to implement these requirements, which would allow the rule to take effect quickly. The ETS may be challenged in court, so potentially impacted employers should watch for developments closely.

President Biden's executive order also requires COVID-19 vaccination for contractors that do business with the federal government. On September 24, 2021, guidance was released on this requirement (this guidance was updated on November 10, 2021).

Note: Separately, vaccination requirements will also apply to employees at Medicare and Medicaid participating hospitals and other healthcare settings that receive Medicare or Medicaid reimbursement.

State Mandates:

Through regulations, executive orders, and emergency health orders, numerous states have adopted COVID-19 vaccination requirements. These requirements have targeted certain types of employees, such as healthcare workers and state employees. In some cases, employees may be able to submit to regular testing (and follow other safety protocols) instead of receiving the COVID-19 vaccine. In others, there is no alternative to vaccination and covered employees must generally be vaccinated by a certain deadline.

The following chart includes many of the states with vaccination requirements or vaccination/testing requirements and examples of the types of workers covered. The chart is current as of September 28, 2021.

States with a COVID-19 vaccination mandate or a vaccination/testing mandate:


Examples of Covered Workers


Healthcare workers, workers in high-risk congregate settings, school employees, and state employees


Healthcare workers, state employees, and contractors who enter state facilities


Nursing home staff, long-term-care workers, childcare staff, school staff, and state employees


Healthcare workers, long-term-care workers, and state employees

District of Columbia

Workers in schools and childcare centers and employees and contractors of the District of Columbia


State and county employees and contractors at state facilities


Healthcare workers, including nursing home employees, school employees, higher education personnel, and state employees and contractors at state-owned or operated congregate facilities


Healthcare workers, EMS personnel, and dentists


Employees of nursing homes and hospitals and state employees in congregate care settings


Workers at skilled nursing facilities, nursing homes, rest homes, assisted living residences, hospice programs, home care workers, and employees of the Executive Department


State agency employees


State employees

New Jersey

Healthcare workers, workers at high-risk congregate settings, childcare personnel, school personnel, state contractors at state agency locations, and state employees

New Mexico

Workers at medical close-contact congregate settings, workers at schools, and state employees

New York

Healthcare workers, school employees, and state employees

North Carolina

State employees


Healthcare workers, school employees, and Executive Branch employees


Employees in state healthcare facilities and high-risk congregate care facilities

Rhode Island

Healthcare workers


State workers


State employees who work with vulnerable populations and Executive Branch employees


Healthcare workers, long-term-care workers, childcare workers, state employees and onsite state contractors, school employees, and higher education employees


Executive Branch employees

Under some of the above requirements, employees may be entitled to an exemption for their sincerely held religious beliefs and/or medical conditions. Employers should read applicable rules and orders in full and consult legal counsel to determine their rights and responsibilities. Keep in mind that requirements may be spread among multiple rules/orders and may continue to be amended.

Local Mandates:

Some local jurisdictions have adopted their own COVID-19 vaccination requirements. For example, New York City’s mayor issued an executive order that generally prohibits employees from entering an employer’s indoor premises without displaying proof of vaccination. Several local jurisdictions in California and other states have also adopted vaccination requirements, but many apply to a narrower set of employees. Check your local rules for details.


More state and local jurisdictions are likely to adopt vaccination requirements. Watch closely for developments.

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