Legacy Health operates eight hospitals in Oregon and Washington. In August 2021, as the COVID-19 Delta variant spread and hospitalizations increased, Legacy adopted a vaccination policy requiring individuals who worked at its hospitals to become vaccinated or obtain a medical or religious exemption. Nine employees at Legacy’s Salmon Creek Medical Center, including nurses, respiratory therapists, technicians, and a physician assistant, requested religious exemptions. Legacy denied the requests, placed the employees on administrative leave, and ultimately terminated all but one employee, who later chose to receive the vaccine and returned to work.
The employees sued Legacy Health and Northwest Acute Care Specialists, asserting religious-discrimination claims under Title VII and Washington law. They alleged that the employers failed to accommodate their religious objections to vaccination. Legacy moved for summary judgment and argued that granting religious exemptions would impose an undue hardship on its healthcare operations. The trial court agreed and granted summary judgment in Legacy’s favor. The employees appealed.
The Ninth Circuit analyzed the undue hardship standard. Title VII requires employers to reasonably accommodate employees’ religious beliefs unless doing so imposes an undue hardship on the employer’s business. The Ninth Circuit explained that, under Groff v. DeJoy, a recent Supreme Court case, an employer establishes undue hardship by showing that a proposed accommodation would impose a substantial burden in the overall context of its business. The Ninth Circuit also explained that undue hardship may include health and safety risks and operational burdens, not just financial costs.
The Ninth Circuit considered whether Legacy established undue hardship. The employees argued that Legacy improperly denied their requests for religious exemptions. Legacy argued that exempting unvaccinated frontline healthcare workers during the Delta-variant surge would create significant risks to patients, staff, and hospital operations.
The Ninth Circuit agreed with Legacy. The Ninth Circuit found that Legacy presented unrebutted expert evidence showing that vaccination reduced transmission risks and that alternative safety measures, such as masking, testing, and other protective equipment, were not effective substitutes for vaccination in the healthcare setting. The Ninth Circuit also found that granting the requested exemptions would create three related risks: infected employees could miss work and create staffing shortages, infected employees could expose coworkers needed to care for patients, and infected employees could transmit COVID-19 to vulnerable patients. The Ninth Circuit concluded that those risks created a substantial burden on Legacy’s business of providing safe and effective healthcare.
The employees argued that other hospitals granted religious exemptions and that later data suggested accommodating a small number of unvaccinated employees would not create significant risks. The Ninth Circuit concluded that the undue-hardship inquiry focuses on the circumstances facing the particular employer at the time of the decision. Because Legacy relied on the scientific and medical information available during the Delta-variant surge, and because the employees offered no evidence rebutting Legacy’s expert testimony, the Ninth Circuit found those arguments unpersuasive.
The Ninth Circuit then addressed the employees’ argument that Legacy failed to consider alternative accommodations in good faith. The employees argued that Legacy could not rely on an undue-hardship defense because it denied exemption requests without individualized consideration of alternative accommodations. The Ninth Circuit rejected that argument. The Ninth Circuit explained that an employer may rely on undue hardship as a complete defense if no reasonable accommodation would avoid the hardship. The Ninth Circuit further found that Legacy’s evidence established that no effective alternative to vaccination existed for employees who worked in close contact with patients and staff. Because the employees offered no evidence creating a factual dispute on that point, the Ninth Circuit concluded that no reasonable jury could find that a workable accommodation existed.
The Ninth Circuit affirmed the trial court’s judgment. The Ninth Circuit held that Legacy established undue hardship as a matter of law because granting religious exemptions to unvaccinated frontline healthcare workers during the COVID-19 Delta-variant surge would have imposed substantial health, safety, and operational burdens on its healthcare system.
Williams v. Legacy Health (9th Cir. 2026) 174 F.4th 1201.
Note: Although this case involves a hospital setting during the COVID-19 pandemic, the Ninth Circuit’s analysis provides useful guidance for schools evaluating religious accommodation requests. The decision reinforces that employers may establish undue hardship for religious accommodation requests through health, safety, and operational risks, not just financial costs, and that courts will assess those risks in light of the employer’s particular operations and the information available at the time of the decision.