Labor & Employment Law Daily Wrap Up, DISCRIMINATION—RELIGIOUS—3d Cir.: Physician, denied COVID vaccine exemption, cannot revive claims against Main Line Health, (Apr 11, 2025)

By Jason Albright, J.D.

His regular duties required him to work in-person in the emergency room and to interact with patients, including those with COVID-19.

A former attending physician for Main Line Health (MLH), placed on administrative suspension after he failed to get a COVID-19 vaccination under the employer’s mandatory vaccination policy, cannot revive his Title VII or Pennsylvania Human Relations Act religious accommodation claims, the Third Circuit affirmed in a nonprecedential opinion. MLH showed, and the physician admitted, that he treated vulnerable patients in the normal course of his clinical duties and interacted with patients with COVID, and it provided unrebutted expert testimony that unvaccinated healthcare workers presented an increased risk of transmitting COVID to others, particularly when they interacted with vulnerable groups. Substantial, undisputed evidence thus established undue hardship from his requested religious accommodation, and he also failed to show that his suspension was retaliatory (Bushra v. Main Line Health, Inc., No. 24-1117 (3d Cir. Apr. 10, 2025, nonprecedential)).

A Philadelphia story. The plaintiff has worked in Main Line Health’s Lankenau Medical Center for more than 20 years, most recently as an attending physician and Campus Chief of the Emergency Department. His regular duties required him to work in-person in the emergency room and to interact with patients, including those with COVID-19.

Mandatory vaccination policy. In July 2021, MLH adopted a mandatory vaccination policy that required its employees and staff to show proof of COVID-19 vaccination by October 1, 2021. Alternatively, MLH offered the opportunity to request medical or religious exemptions, but it cautioned that “it is possible that there may not be a reasonable accommodation that will allow every person with such an exemption to continue to work onsite while unvaccinated.” MLH approved “some” religious exemption requests, but the record did not indicate whether or how it accommodated those individuals.

Religious exemption denied. The physician applied for a religious exemption to MLH’s COVID-19 vaccination policy, which MLH denied. In so doing, MLH informed him that it had determined that he “did not articulate a sincerely held religious belief that is contrary to receiving the COVID-19 vaccination.”

Suspension, unsuccessful suit, and appeal. The physician did not get the COVID-19 vaccination, and on November 15, 2021, MLH placed him on administrative suspension. He then sued MLH for religious discrimination in March 2023, and in December 2023, a federal district court granted summary judgment to MLH. He timely appealed.

Case hinges on undue hardship. The Third Circuit first observed that the physician’s arguments on appeal largely challenged the district court’s determination that MLH established the undue hardship defense to his religious discrimination claims. “There is no violation of Title VII or the PHRA where an employer ‘demonstrates that he is unable to reasonably accommodate to an employee’s or prospective employee’s religious observance or practice without undue hardship on the conduct of the employer’s business.’

Undue hardship present. Here, the appeals court found that MLH met its burden of demonstrating undue hardship, or a hardship that is “substantial in the context of [its] business.” It showed, and the physician admitted, that he treated vulnerable patients in the normal course of his clinical duties and interacted with patients with COVID-19. Hospital settings such as the medical center facilitated COVID transmission between patients and healthcare workers, and MLH provided unrebutted expert testimony that unvaccinated healthcare workers, like the physician, presented an increased risk of transmitting COVID to others, particularly when they interacted with vulnerable groups.

Patients and employees at MLH died from COVID, the Third Circuit noted, COVID’s on-site spread compromised MLH’s mission and ability to care for sick patients, and COVID jeopardized the health and efficacy of MLH’s employees and staff. MLH’s expert additionally testified, contrary to the physician’s assertion, that alternative infection control strategies, such as frequent testing and masking, were not sufficient to prevent transmission. The appeals court thus agreed with the district court that this substantial, undisputed evidence established undue hardship.

Summary judgment against the religious accommodation claims was thus affirmed.

No retaliation. The physician’s retaliation claim fared similarly. Even if his request for a religious exemption and subsequent appeals were protected activities, and assuming that his administrative suspension was an adverse employment action, the physician nonetheless failed to demonstrate causation. He provided no support for his contention that he was suspended because he requested a religious exemption rather than because he failed to follow the mandatory vaccine policy, concluded the appeals court.

The case is No. 24-1117.

Judge: Roth, J.

Attorneys: David M. Koller (Koller Law) for Joseph Bushra. Brendan Hennessy (Hennessy Law) for Main Line Health Inc.

Companies: Main Line Health Inc.

Cases: ReligiousDiscrimination Discrimination Covid19 DelawareNews NewJerseyNews PennsylvaniaNews