Labor & Employment Law Daily Wrap Up, DISCRIMINATION—RELIGIOUS—7th Cir.: Hospital pharmacist, fired after refusing COVID vaccine, failed to show religious discrimination, (Sep 29, 2026)

By Jason Albright, J.D.

Based on epidemiological guidance, the county determined that exemptions could be granted only to employees whose jobs could be performed fully remotely.

Cook County was entitled to summary judgment against the Title VII religious discrimination claim of a hospital pharmacist who was fired after she refused to comply with its mandatory COVID-19 vaccination policy and did not qualify for a religious exemption, the Seventh Circuit affirmed. Once the vaccine was available, the county determined, based on scientific research and CDC guidance, that masking and social distancing alone did not adequately reduce risks to patient and employee safety nor the operational costs of likely staff shortages. The pharmacist regularly interacted with patients and visited patient floors, where the risks and consequences of spreading the COVID-19 virus were high, and the county thus would have faced undue hardship by exempting her. Judge Taibleson dissented (Mason v. Cook County, Illinois, No. 25-2743 (7th Cir. Sept. 28, 2026)).

Hospital pharmacist. The plaintiff, according to the court, was an employee of Cook County Health, which is operated by Cook County. The county operates John H. Stroger Jr. Hospital, where she worked as a pharmacist from 2010 through May 2022. She worked in a room with 20 other pharmacists and 40 pharmacy technicians. She also counseled patients from the pharmacy window one day per month, and she brought medications to the floor of the hospital where patients with COVID-19 were treated.

Vaccine mandate. The COVID-19 pandemic strained the county’s short-staffed healthcare system. Alongside a wave of infections in the general population, hospital staff contracted the virus at increasingly high rates. Seeking to limit the spread of the virus, the county implemented a policy in August 2021 mandating that staff members receive the COVID-19 vaccine by October 2021.

Basis of policy. The county based its policy on guidance from federal and state public health authorities. The Center for Disease Control and Prevention (CDC) found that COVID-19 vaccination was the best way to reduce transmission and prevent severe illness, hospitalization, and death. Other evidence showed a vicious cycle of infection within hospitals: health care workers faced increased risk of contracting COVID-19 through patients and fellow staff, and healthcare workers in turn faced increased risk of infecting their medically vulnerable patients. The county determined that other mitigation methods alone, such as masking, social distancing, and testing, did not sufficiently address patient and employee safety.

Religious exemptions. Employees could request an exemption from the mandatory vaccination policy based on a sincerely held religious belief. Based on guidance from the county’s Infection Control and Epidemiology Department and the CDC, however, the county determined that exemptions could be granted only to employees whose jobs could be performed fully remotely.

Even employees not engaged in direct patient care needed to be vaccinated for in-person work, the county determined, because they had close contact with other employees who did have patient care duties. Approximately 102 Cook County Health employees sought a religious exemption, and exemptions were granted to nine employees who could work remotely.

Exemption request. In September 2021, the pharmacist requested an exemption from the vaccine mandate based on her Christian faith. Among other things, her request quoted 1 Corinthians 6:19: “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own for you were bought with a price. So glorify God in your body.”

Denied and fired. The county informed the pharmacist that it could not grant her request because doing so would “compromise workplace safety… [and] pose an undue hardship.” The county allowed her 90 days to apply for a remote position within its system. No such positions were available, however, and at the end of the 90-day period, in May 2022, the county fired her.

Lawsuit. The employee sued the county, alleging that its denial of a religious accommodation and later discharge violated Title VII. She also alluded to a discrimination claim based on disparate treatment, stating that another county employee with the title “Sanitarian I” violated the vaccine policy but was not fired as she was. The other employee, who worked in Rolling Meadows for the Department of Public Health, was participating in a blind study on the COVID-19 vaccine but ultimately received the vaccine.

Decision below and appeal. The county moved for summary judgment, and the district court granted the motion. The district court assumed that the pharmacist could establish a prima facie case of religious discrimination based on the county’s failure to accommodate a religious belief, but it concluded that no reasonable juror could find that the county could accommodate her request without suffering undue hardship. Allowing her to work unvaccinated during a public health crisis would have “jeopardized the health of [County] staff and patients,” according to the district court. It also determined that the Sanitarian I employee was not similarly situated to the pharmacist. She timely appealed to the Seventh Circuit.

Failure to accommodate. Affirming, the appeals court agreed with the district court that the county made an adequate showing that accommodating the pharmacist could not be accomplished without undue hardship, and that no triable issues of material fact remained. It provided declarations from its Associate Chief Human Resources Officer, Equal Employment Opportunity Director, and Department Chair of Infection Control and Epidemiology, and they described its decision-making process regarding the protective measures taken throughout the pandemic. They explained that the county’s operations had been jeopardized by healthcare workers’ high risk of contracting and transmitting COVID-19 compared to the general population.

According to the county officials, outbreaks among staff strained the county’s ability to provide necessary services, and vaccination afforded additional protection against the increased risk of staff contracting COVID-19 and infecting medically vulnerable patients. Thus, once the vaccine was available, the county determined, based on scientific research and CDC guidance, that masking and social distancing alone did not adequately reduce risks to patient and employee safety nor the operational costs of likely staff shortages.

And the employee worked as a pharmacist in a hospital setting. She not only worked in the same room with numerous other pharmacists and technicians, noted the court, as a pharmacist she also regularly interacted with patients and visited patient floors, where the risks and consequences of spreading the COVID-19 virus were high. That was sufficient to establish that the county would have faced undue hardship by exempting her.

Disparate treatment. Finally, the Seventh Circuit rejected the pharmacist’s “conclusory challenge to the district court’s determination that she could not identify an apt comparator to make out a disparate treatment claim of religious discrimination.” She invoked the example of the Sanitarian I employee who was not fired, but the two employees were not comparable, according to the appeals court. She and the Sanitarian I had completely different jobs, in different locations, with different supervisors. The plaintiff worked as a pharmacist at Stroger Hospital in Chicago for Cook County Health, while the Sanitarian I worked for the Department of Public Health in Rolling Meadows, Illinois. And finally, the Sanitarian I, unlike the pharmacist, neither sought nor was granted an exemption.

Dissent. Dissenting, Judge Taibleson argued that, although alternatives to vaccination, such as masking, testing, socially distancing, and partial remote work, were available, the county failed to show that permitting those alternatives for the pharmacist would have presented an unjustifiable burden.

The case is No. 25-2743.

Judge: Lee, J.

Attorneys: Jonathan Lubin (Law Offices of Jonathan Lubin) for Brooke Mason. Kathleen Cunniff Ori, Office of the Cook County State's Attorney, for Cook County.

Companies: Cook County, Illinois

Cases: ReligiousDiscrimination Discrimination Discharge Covid19 IllinoisNews IndianaNews WisconsinNews