COVID vaccination mandates may be behind us, but the lawsuits they generated are still shaping how courts analyze religious accommodation under Title VII. This Third Circuit decision is a reminder that an accommodation can still be challenged when it allegedly creates a new burden.
TL;DR: The Third Circuit revived Title VII religious accommodation claims challenging an employer’s vaccination-policy accommodation. The employees did not claim a religious objection to testing itself, but alleged the accommodation required twice-weekly nasal swab testing using swabs sterilized with ethylene oxide, which they characterized as a carcinogen. At the motion-to-dismiss stage, the court held those allegations were enough to proceed to discovery on whether the accommodation could be unreasonable under the circumstances.
📄 Read the Third Circuit’s decision
The accommodation that sparked the dispute
During the COVID-19 pandemic, a hospital system implemented a mandatory vaccination policy. According to the complaint, employees who objected on religious grounds could receive an exemption only if they submitted to twice-weekly nasal swab testing.
The employees alleged the swabs were sterilized with ethylene oxide, which they characterized as a carcinogen, and asked to be excused from testing. The employer denied those requests, and more than 100 employees sued under Title VII.
Why the accommodation itself became the problem
The district court dismissed the case on the ground that the employees’ objection to nasal-swab testing was medical, not religious, and therefore could not support a Title VII claim. On that point, the Third Circuit largely agreed.
The court held that the employees did not allege a religious objection to nasal-swab testing itself, and that such a conflict could not reasonably be inferred from the complaint. Standing alone, that would normally end the analysis.
But the Third Circuit emphasized that Title VII does not ask only whether an accommodation avoids a direct conflict with religious belief. It also asks whether the accommodation is reasonable under the circumstances. And at the pleading stage, that inquiry focuses on the burden the accommodation allegedly places on the employee.
Here, the employees alleged that the accommodation required twice-weekly testing using swabs sterilized with ethylene oxide, which they characterized as a carcinogen. Accepting those allegations as true, the court concluded the employees had sufficiently alleged that the accommodation itself could be unreasonable, even if it eliminated the religious conflict with vaccination.
What the court explicitly left for another day
The court did not hold that the accommodation was unreasonable. It did not weigh medical evidence or decide whether ethylene oxide exposure from nasal swabs poses any real danger.
A dissent would have affirmed dismissal, reasoning that testing eliminated the religious conflict and that medical concerns about testing should not support a Title VII accommodation claim. The majority disagreed, but only at the pleading stage.
The practical lesson for employers making accommodation decisions
- How employers handle accommodations often shapes risk long before lawyers get involved. Early decisions about process, communication, and follow-through can matter as much as the accommodation itself.
- Offering an alternative doesn’t end the process if employees can point to a real concern with the alternative itself. Employers should continue to engage in good faith, evaluate that concern, and respond accordingly.
- Reasonableness includes how an accommodation works in practice. Courts may look beyond policy design to how the accommodation actually affects employees day to day.
- Health and safety concerns tied to accommodations should be addressed and documented. Even if those concerns later prove unfounded, failing to engage with them can create avoidable risk.
- Labeling an objection as “medical” doesn’t always shut things down. When concerns relate to the accommodation itself, employers should expect closer scrutiny.
The takeaway employers should not miss
This decision is about pleadings, not proof. When an accommodation allegedly creates a new burden, courts are likely to let the record develop before deciding who is right.