Before You Use a COVID-19 Vaccine Declination Letter

A vaccine declination letter is not automatically the same thing as a legally protected exemption.

Your rights depend on why you are requesting the exception, where you work, the applicable policy, the size and type of employer, your job duties, and federal, state, or local law.

A personal preference or philosophical objection that is not religious in nature does not automatically qualify as a religious accommodation under Title VII. The EEOC explains that social, political, economic, and personal preferences are not treated as religious beliefs simply because you strongly believe them.

Likewise, a medical accommodation normally requires an individualized evaluation under the ADA when a disability prevents you from satisfying an applicable workplace requirement.

If your medical situation affects your ability to work in other ways, review [Leave of Absence Letter Samples] before deciding whether an accommodation request, leave request, or both would be more appropriate.

What Has Changed About COVID-19 Vaccine Guidance?

COVID-19 vaccine recommendations have changed significantly since the earliest years of the pandemic.

As of August 9, 2026, the CDC’s currently posted routine COVID-19 vaccination guidance is its 2025–2026 guidance. It recommends vaccination for people age 6 months and older through individual-based decision-making, sometimes described as shared clinical decision-making, with the balance of benefits and risks varying by age and health circumstances.

That is one reason you should avoid copying an old declination letter that makes sweeping claims about vaccination recommendations.

Your letter should focus on your specific accommodation request and the organization’s current policy, rather than arguing broadly about COVID-19 vaccines.

Template 1 — Medical COVID-19 Vaccine Accommodation Request

Use this template when a medical condition or disability prevents you from complying with an employer’s vaccination requirement.

The ADA may require a covered employer to consider reasonable accommodation when a disability prevents an employee from complying with a vaccination requirement. The analysis is individualized, and employers may consider whether an effective accommodation is available.

If you need additional language for explaining a medical situation without oversharing, see [How to Write a Medical Hardship Letter].

Subject: Request for Medical Accommodation Regarding COVID-19 Vaccination

Dear [HR Manager/Occupational Health Representative],

I am writing regarding [Company/Organization Name]‘s COVID-19 vaccination requirement.

Because of a medical condition, I am requesting a reasonable accommodation from the vaccination requirement. My healthcare provider has advised me regarding my medical circumstances and my ability to receive the vaccine.

I am prepared to provide appropriate medical documentation that confirms the need for this accommodation, if documentation is required.

I would appreciate the opportunity to discuss reasonable alternatives that would allow me to continue performing my job safely and effectively. Depending on company requirements and my job duties, possible alternatives may include modified work arrangements, masking, testing, schedule adjustments, reassignment, or another effective accommodation.

Please let me know what forms or documentation you need from me to begin the accommodation review process.

Thank you for your consideration.

Sincerely,

[Your Name]
[Job Title]
[Department]
[Employee ID]
[Phone Number]
[Email Address]

Why This Template Works

You do not need to turn your letter into a detailed medical history.

You identify the medical basis, request the accommodation directly, offer documentation, and invite the employer to discuss alternatives.

The EEOC states that employee medical information, including information connected with reasonable accommodations and vaccination status, generally must be treated as confidential medical information and maintained separately from ordinary personnel files.

Template 2 — Temporary Medical Deferral of COVID-19 Vaccination

Sometimes you are not requesting a permanent exemption. You may only need additional time because of a current medical circumstance.

CDC guidance recognizes specific contraindications and precautions. For example, moderate or severe acute illness can warrant deferring vaccination until the illness improves, while certain previous vaccine reactions or myocarditis/pericarditis circumstances require individualized medical consideration.

Do not diagnose yourself or claim that you have a CDC-recognized contraindication unless your medical situation actually supports that statement.

Subject: Request for Temporary Medical Deferral of COVID-19 Vaccination

Dear [HR Manager/Occupational Health Representative],

I am writing to request a temporary medical deferral from [Company/Organization Name]‘s COVID-19 vaccination requirement.

My healthcare provider has advised me to postpone vaccination until approximately [date] because of my current medical circumstances.

I am requesting that my vaccination deadline be extended until [date], at which time I will review my situation again with my healthcare provider.

If needed, I can provide appropriate documentation supporting the temporary deferral.

During the deferral period, I am willing to discuss any reasonable workplace requirements or temporary adjustments that may apply to my position.

Please confirm whether this request can be approved and whether you need any additional documentation from me.

Thank you for your consideration.

Sincerely,

[Your Name]
[Job Title]
[Department]
[Employee ID]

Why This Template Works

A temporary request can be easier for a reviewer to evaluate because you provide a specific review date rather than making an open-ended request.

If the underlying medical issue also affects your attendance, schedule, or ability to perform certain duties, you may want to review [Leave of Absence Letter Templates].

Template 3 — Religious COVID-19 Vaccine Accommodation Request

Use this template when receiving the vaccine conflicts with your sincerely held religious belief, practice, or observance.

Title VII requires covered employers to consider reasonable accommodation for sincerely held religious beliefs unless accommodation would impose an undue hardship. Under the current Supreme Court standard, the employer must show that the burden would be substantial in the overall context of its business.

You do not need to write a theological essay.

Your goal is to clearly communicate that your objection is religious in nature and that the vaccination requirement conflicts with your sincerely held belief.

Subject: Request for Religious Accommodation Regarding COVID-19 Vaccination

Dear [HR Manager/Compliance Officer],

I am writing to request a religious accommodation regarding [Company/Organization Name]‘s COVID-19 vaccination requirement.

Receiving the COVID-19 vaccine conflicts with my sincerely held religious beliefs, practices, or observances. For that reason, I am requesting an accommodation from the vaccination requirement.

My request is based on my personal religious convictions and is being made sincerely.

I am willing to participate in the accommodation process and discuss reasonable alternatives that would allow me to continue performing my responsibilities while meeting applicable workplace requirements.

Please let me know whether you require an accommodation form or additional information to evaluate my request.

Thank you for reviewing my request.

Sincerely,

[Your Name]
[Job Title]
[Department]
[Employee ID]

How Much Should You Explain?

You should provide enough information to make it clear that the conflict is religious rather than merely a personal, political, or philosophical objection.

The EEOC says employers should ordinarily assume a religious accommodation request is based on a sincerely held religious belief. However, an employer may seek additional supporting information when it has an objective basis for questioning the religious nature or sincerity of the belief.

You should therefore be truthful and consistent.

Do not copy someone else’s religious explanation if it does not genuinely describe your beliefs.

Template 4 — Pregnancy-Related COVID-19 Vaccine Accommodation Request

Pregnancy-related workplace accommodations now deserve particular attention because the Pregnant Workers Fairness Act, or PWFA, expanded federal protections for workers with known limitations related to pregnancy, childbirth, or related medical conditions.

The PWFA generally requires covered employers to provide reasonable accommodations for known pregnancy-related limitations unless the accommodation would create an undue hardship.

EEOC COVID-19 guidance also explains that a pregnant employee requesting an exception from a vaccination requirement must not be treated less favorably simply because of pregnancy.

Subject: Request for Pregnancy-Related Accommodation Regarding COVID-19 Vaccination

Dear [HR Manager/Occupational Health Representative],

I am writing regarding [Company/Organization Name]‘s COVID-19 vaccination requirement.

I am currently [pregnant / experiencing a pregnancy-related medical condition], and I am requesting an accommodation concerning the vaccination requirement based on my current pregnancy-related circumstances.

I would appreciate an individualized review of my request under the company’s accommodation procedures and any applicable pregnancy accommodation requirements.

I am willing to discuss reasonable temporary alternatives that would allow me to continue performing my job effectively.

If appropriate, I can provide documentation from my healthcare provider regarding my pregnancy-related limitations and the accommodation being requested.

Please let me know what information or forms you need from me.

Thank you for your consideration.

Sincerely,

[Your Name]
[Job Title]
[Department]

Why You Should Avoid Making Medical Claims in This Letter

Your letter should not state that pregnancy automatically makes COVID-19 vaccination medically contraindicated.

Instead, explain your actual pregnancy-related limitation or medical recommendation and request an individualized review.

If your pregnancy or another medical condition requires schedule changes, reduced hours, or time away from work, [Work Schedule Change Memo Samples] may help you organize a separate schedule request.

Template 5 — COVID-19 Vaccine Declination With Proposed Workplace Alternatives

You can use this version when an organization allows declination requests or when you want to propose alternatives while your request is being reviewed.

This template is especially useful in healthcare, client-site, caregiving, contracting, and other workplaces where infection-control requirements may affect your duties.

However, simply offering alternatives does not guarantee that your employer must approve your request. Whether a legal accommodation requirement exists depends on the basis for the request and the circumstances.

The EEOC has identified possible accommodations in vaccination situations that can include modified shifts, telework, reassignment, masking, distancing, or periodic testing, depending on whether the alternative is effective and appropriate for the workplace.

Subject: COVID-19 Vaccine Declination and Request to Discuss Alternative Measures

Dear [HR Manager/Infection Control Representative/Project Manager],

I am writing regarding the COVID-19 vaccination requirements applicable to my position at [Company/Facility/Site].

I am requesting permission to decline the COVID-19 vaccination requirement based on [briefly identify your applicable medical, religious, pregnancy-related, or policy-based reason].

I would like to discuss whether an alternative arrangement is available that would allow me to continue performing my responsibilities while complying with applicable workplace and safety requirements.

Depending on the requirements of my position, I am willing to discuss measures such as masking, testing, schedule modifications, work-location changes, reassignment, or other reasonable alternatives considered appropriate by the organization.

Please let me know what process I should follow and whether additional documentation is required.

Thank you for reviewing my request.

Sincerely,

[Your Name]
[Job Title]
[Department/Work Location]
[Employee ID]

How to Make Your COVID-19 Vaccine Declination Letter Stronger

You will usually have a stronger request when your letter focuses on the accommodation process instead of trying to debate the organization’s entire vaccination policy.

Keep your explanation factual.

State exactly what you want.

If the request is medical, provide only the documentation that is reasonably necessary. If it is religious, explain the sincere religious conflict without turning the letter into a general argument against vaccination.

You should also save a copy of your letter, supporting documents, HR forms, and the employer’s response.

If your employer denies your request and you believe you are being treated unfairly because of a protected characteristic or because you requested an accommodation, [Unfair Treatment at Work Letter Samples] can help you document what happened.

What Documents Should You Attach?

What you attach depends on the reason for your request.

For a medical accommodation, your employer may request reasonable medical information when the disability or need for accommodation is not obvious. You generally do not need to volunteer your complete medical history. The ADA also places confidentiality requirements on medical information obtained by an employer.

For a religious accommodation, you should not automatically assume that a letter from a clergy member is required. The key question is generally whether the belief is religious in nature and sincerely held, although additional information can sometimes be requested when there is an objective reason to question the request.

For pregnancy-related accommodation, documentation rules depend on the particular limitation and requested accommodation. The PWFA provides broader accommodation protections for qualifying pregnancy, childbirth, and related limitations.

Medical Contraindication vs. Personal Concern

You should be careful with the term medical contraindication.

A medical contraindication has a specific clinical meaning. You should not describe a general concern about side effects as a recognized contraindication unless your healthcare professional has determined that it applies to you.

CDC currently identifies specific contraindications and precautions associated with COVID-19 vaccination, including certain serious allergic reactions and particular clinical circumstances.

If you need to document a medical decision for another type of review or appeal, [Medical Necessity Appeal Letter Samples] can give you additional examples of how to organize supporting medical information.

What to Do if Your Accommodation Request Is Denied

A denial does not necessarily mean your employer acted illegally, and an accommodation request does not guarantee that you will receive your preferred accommodation.

The employer may evaluate whether the requested accommodation is effective and whether it creates an applicable undue hardship. Different standards can apply to disability, religion, and pregnancy-related requests.

If your preferred accommodation cannot be provided, you can ask whether another effective accommodation is available.

You should request the decision in writing whenever possible and keep a copy of the explanation.

Recent EEOC enforcement actions show that COVID-19 vaccination accommodation disputes have not disappeared simply because widespread pandemic-era mandates have declined. In 2026, the EEOC announced settlements and litigation involving employees who alleged that religious or disability-based vaccine accommodation requests were improperly denied.