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What Workers Need to Know About the Federal Vaccine Requirements

New guidelines for private employers and health care facilities affect more than 100 million workers

Women is getting a shot in the arm from a doctor

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Editor’s Note: On Nov. 19, 2021, the Occupational Safety and Health Administration (OSHA) suspended the implementation and enforcement of its workplace COVID-19 vaccine requirements pending the outcome of ongoing litigation. The following article describes how the OSHA requirements will work if they are legally allowed to proceed. This article will be updated regularly.

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People who work for any business with 100 or more employees have until Jan. 4 to get fully vaccinated for COVID-19, according to guidelines issued by the White House today. After that date, unvaccinated workers must either take weekly tests showing that they are not infected with the coronavirus or risk being removed from the workplace.

Under a second guideline issued by the administration today, all workers at health care facilities that participate in Medicare or Medicaid will also need to be fully vaccinated by Jan. 4. These workers will not have the option of submitting to weekly tests in lieu of vaccination.

Taken together, the new requirements will apply to more than 100 million workers. It’s a number that could significantly boost the share of American adults who are vaccinated. So far, when employers have enacted vaccine mandates for their workers, only small percentages of those employees have declined to be vaccinated. New York City, for example, required vaccinations for its employees, and by the time the deadline arrived, more than 91 percent had received at least one shot.

“Vaccination requirements are good for the economy,” President Biden said in a statement. “They not only increase vaccination rates but they help send people back to work — as many as 5 million American workers. They make our economy more resilient in the face of COVID and keep our businesses open.”

These new mandates are in addition to earlier requirements for federal executive branch employees and government contractors, who also must now meet the Jan. 4 deadline. Here’s what workers need to know about the federal vaccination requirements for employers.


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Workers must be vaccinated by Jan. 4 or submit to weekly tests.

If you work for an employer that has 100 or more workers, you will need to be fully vaccinated with either two shots of the Pfizer or Moderna vaccines or one shot of the Johnson & Johnson vaccine by the Jan. 4 deadline. Although some state and local governments have issued or are pursuing laws that prohibit employers from mandating COVID-19 vaccinations, this new federal guidance from the Occupational Health and Safety Administration (OSHA) will preempt those regional policies, according to the White House. This vaccine requirement will apply to an estimated 84 million people.

The new federal policy does allow exemptions to the vaccine mandate for medical or religious reasons. But while, because of privacy policies, it’s unclear how many workers have requested religious exemptions from their employers, most requests and lawsuits seeking religious exemptions from COVID-19 vaccination mandates so far have been denied.

If you decline to be vaccinated or test positive for COVID-19 after Jan. 4, your employer will be required to remove you from the workplace. If you are a remote worker, you may be exempt from the vaccination requirement, depending on your employer’s policies. The OSHA guidelines say such workers may be exempt because they do not interact with other people within a workplace.

There is another notable point in the federal requirement. Workers who opt to submit to weekly tests instead of getting vaccinated will have to pay for those tests themselves unless there is a collective bargaining agreement or local law that requires the employer to cover such costs. While there are free testing options in some communities, the price of a COVID-19 test can range from $24 for the over-the-counter quick-testing options available at pharmacies to the median price of $148 for a test at a hospital.

The federal policy also requires employers that fall under this regulation to pay workers for the time it takes them to get vaccinated and to provide paid sick leave to those who may need time to recover from the immediate side effects of the vaccination process.

Workers at Medicare and Medicaid facilities don’t get to choose testing instead.

Under the new requirement issued by the Centers for Medicare & Medicaid Services (CMS), all workers at the 76,000 health care facilities nationwide that participate in those federal programs will have to get vaccinated by Jan. 4. These employees will not have the option of submitting to weekly tests instead.

This vaccination requirement applies to all workers regardless of whether they directly interact with patients. Workers who contract with these facilities will also be required to be vaccinated. All told, more than 17 million people will fall under this new CMS requirement, according to White House estimates.

Kenneth Terrell covers employment, age discrimination, work and jobs, careers, and the federal government for AARP. He previously worked for the Education Writers Association and U.S. News & World Report, where he reported on government and politics, business, education, science and technology, and lifestyle news.

Editor’s note: This article originally was published on November 4, 2021. It has been updated with information about OSHA suspending implementation of its workplace vaccine mandate.