Labor & Employment Law Daily Wrap Up, DISCRIMINATION—RELIGIOUS—6th Cir.: LPN’s request to be exempt from COVID-19 vaccine and weekly testing posed undue hardship, (Sep 12, 2025)

By Kathleen Kapusta, J.D.

In her accommodation request, the LPN stated that her request “for accommodation is that I do not consent to getting a covid vaccine [or] taking a covid test.”

A licensed practical nurse who objected on religious grounds to her employer’s mandatory COVID-19 vaccination policy, and to COVID testing, failed to show that she put the medical center on notice that she had a change of heart about what types of tests she was willing to take, the Sixth Circuit concluded, finding that the center reasonably understood she would accept only one of two accommodations—either an exemption from all COVID testing or an accommodation allowing her to engage in noninvasive saliva testing. Citing evidence that saliva testing was a less effective method of detecting COVID infection than other forms available at that time, the court, affirming summary judgment against her Title VII failure-to-accommodate claim, found her requested accommodation would have imposed an undue hardship on her employer. The court also affirmed summary judgment against her retaliation claim (Henry v. Southern Ohio Medical Center, No. 24-3863 (6th Cir. Sept. 11, 2025)).

The LPN worked in the medical center’s pediatric office where she had regular contact with patients, including newborns. In August 2021, the medical center announced a mandatory vaccination policy for all staff but permitted employees with religious objections to instead submit to weekly nasopharyngeal testing. It offered oropharyngeal and anterior nares testing, however, for employees with medical conditions requiring alternative methods.

Testing exemption request. Around 300 employees requested exemptions and all but two—the LPN and one other nurse—agreed to weekly testing. According to the LPN, her sincerely held Christian beliefs did not allow her to be “assaulted by a foreign body” being inserted into her nasal passage. The medical center granted all the religious exemptions requests, including the LPN’s, but denied her request for an exemption from testing as it would threaten patient health.

Because this was the medical center’s first refusal to test, the LPN’s request was referred to the ethics committee. Before it was referred, however, the social work and pastoral care director called the LPN and asked her about “foreign objects being inserted into her body.” In response, she explained that her religious objection extended to throat swabs and having “any type of instrument put in her body.” She also proposed that she be allowed to “self-screen” and “stay home if... sick.” A week later, the ethics committee determined that its weekly testing requirement for unvaccinated employees was appropriate and that patients’ right to a safe environment outweighed the LPN’s right not to test.

The next day, the HR director called the LPN and told her she needed to agree to weekly testing by the vaccine deadline. Although she later claimed she asked about alternative testing, the HR director denied that. Later that day, she again asked for an exemption, stating that COVID testing would harm her soul. She said nothing about requesting alternative testing methods. When she continued to refuse weekly testing or vaccination, the medical center placed her on unpaid leave.

Lower court proceedings. Alleging failure to accommodate her religious beliefs and retaliation under Title VII, the LPN sued the medical center. The district court granted summary judgment to her employer.

Failure to accommodate. The Sixth Circuit, on appeal, noted that the district court, in rejecting the LPN’s failure to accommodate claim, found she told the medical center that she wanted an exemption from vaccination and all COVID testing. Although the LPN, in an affidavit, claimed she had requested an alternative to nasopharyngeal COVID testing, the district court found that was a sham because it conflicted with deposition testimony where she admitted she could not remember whether she requested alternative testing.

DeVore. While the appeals court observed that it has long held that an employee must have “informed the employer” of the conflict between her sincere religious belief and the offending employment requirement, it noted that there was little precedent on what it means to inform the employer. In its recent decision in DeVore v. Univ. of Ky. Bd. of Trs., however, the court stated that while the employee there relayed specific objections to the COVID-19 nasal test, she did not establish a conflict between her religious convictions and other forms of testing offered by the employer because she had not explained what the ostensible conflict was.

Devore, said the court, “tells us that [the LPN] had to provide SOMC with reasonably specific objections from which SOMC could determine which tests would infringe on her religious beliefs.” But instead of offering the medical center a reason to believe that she opposed only nasopharyngeal testing, she repeatedly requested an exemption that would cause a reasonable employer to believe that she objected to “both vaccination and testing, no matter the type.”

Specifically, the court observed, in response to the announcement of the vaccination policy, the LPN stated that she wished “to request a religious exemption from... covid testing and vaccines because these are violations of my sincerely held religious beliefs.” Her pastor, in a letter accompanying her accommodation request, stated that her sincerely held religious beliefs included “objection to covid tests, masks, and vaccines.”

Invasive testing. The court noted that there was some reasoning in her accommodation request suggesting her request was limited to exemption from all invasive COVID testing. Generally, said the court, her statements evinced an objection to introducing “substances in the test” or objects for detecting illness into her body, which would also exclude oropharyngeal testing.

In her subsequent conversation with the social work director, she at best objected to all invasive testing, said the court, noting that she asked to be able to self-screen and stay home. She claimed that her deposition testimony and an affidavit showed the medical center knew she objected only to nasopharyngeal testing but in her deposition, she testified that she stated in the phone call with the HR director that she was “not going to agree to weekly testing, that form of weekly testing, and asked if there was any other forms of testing that was acceptable,” but was told no.

But this testimony, said the court, did not indicate she notified the medical center that she objected to only nasopharyngeal testing. Prior to that phone call, the court observed, she maintained a religious objection to every form of testing except possibly saliva and she never told the medical center otherwise. Further, after that phone call, in a letter she delivered to the medical center, she did not say that she was willing to submit to other forms of testing and did not mention any request for alternative testing at all.

Based on this evidence, the court found that the medical center would have reasonably interpreted her request for a “different type of test” to ask only for a noninvasive saliva test and thus the medical center would reasonably have understood her to have been willing to accept only an exemption from all COVID testing or an accommodation allowing her to engage in saliva testing.

Undue hardship. Agreeing with the district court that exempting her from all testing would have imposed an undue hardship, the appeals court pointed to its 2025 decision in Wise v. Child.’s Hosp. Med. Ctr. Of Akron, in which it found that exempting a hospital pharmacist who worked with children from all COVID testing would have imposed an undue hardship because “[t]he hospital cares for particularly vulnerable patients whose lives could be placed at risk if they were to contract the virus” and it was “paramount that Defendant take the highest precautions to ensure the safety of those patients.” That case, said the court, makes clear that exempting the LPN from all testing and vaccination requirements would place an undue hardship on the medical center.

Her request for saliva testing, the court continued, would have also imposed an undue hardship. Here, the court noted evidence showing that saliva testing was a less effective method of detecting COVID infection than other forms of testing available at the time, the medical center did not have the in-house capacity to analyze saliva testing results, and analyzing saliva tests would have required third-party analysis that would have at least doubled the time (from 24 to 48 hours) it took for the medical center to learn whether the LPN tested positive for COVID. In sum, said the court, either of her requested accommodations would have imposed an undue hardship on the medical center.

Retaliation. As to her claim the medical center retaliated against her by placing her on unpaid leave, while she pointed to the fact that she was placed on leave two weeks after she requested an accommodation, the court explained that she was placed on leave the day after the long-established deadline by which every employee had to vaccinate or agree to testing. Nor did she show that the medical center’s stated fear of spreading COVID was pretextual.

The case is No. 24-3863.

Judge: Larsen, J.

Attorneys: Warner D. Mendenhall (Law Offices of Warner Mendenhall) for Christina Henry. Stephen Mark Klyza (Kullman Law Offices) for Southern Ohio Medical Center.

Companies: Southern Ohio Medical Center

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