Philadelphia Health and Academic Institutions Must Prescribe Vaccines by October 15 |  Ballard Spahr LLP

As we previously published, the City of Philadelphia announced that vaccines will be mandatory for healthcare workers and at colleges and universities in the city from October 15, 2021 with no religious or medical exception. On August 16, the Board of Health adopted the Emergency Ordinance to Control and Prevent COIVD-19 Vaccine Requiring Vaccines for Healthcare Professionals and in Higher Education, Healthcare and Related Facilities (“Emergency Ordinance”). The emergency ordinance contains additional details on the vaccination order, exceptions and precautions.

Insured persons

Healthcare: All employees, contractors, students, volunteers, or healthcare workers who are associated with a healthcare facility and perform tasks in a building where patients, customers, or their visitors are present are covered by the Emergency Ordinance – even if their tasks are not direct Contact with others. Healthcare facilities include all natural or legal persons who employ, coordinate or otherwise deal with inpatient or outpatient medical or behavioral health, dental, nursing, medical first aiders, pharmacological, personal nursing homes, assisted living, transitional care, adult day care, long-term care, nursing facility, acupuncture , Audiology, hearing aids, chiropractic, naturopathy, occupational therapy, physiotherapy, sports training, optometry, ophthalmology or speech pathology.

Higher Education: Anyone who works in association with a college, junior college, or university, volunteers, takes part in one or more courses or other activities on campus, and has personal contact with others, is covered by the Emergency Ordinance.

Requirements Effective October 15, 2021

Healthcare facilities may not employ, contract with, or otherwise use the services of an insured person who is not fully vaccinated or has not been vaccinated. Likewise, a higher education institution may not employ persons on campus who are not fully vaccinated or have received a special permit and who adhere to one or more of the accommodations offered, conclude a contract with them or allow them to attend courses.


Healthcare and higher education institutions must grant an exemption to those unable to take the vaccine for medical or religious reasons and make a written commitment to take the necessary precautions.

Medical Exemption: An insured person must apply for a medical exemption by providing a certificate from a licensed health care provider confirming that the exemption applies and the specific reason why the vaccine is contraindicated for the person. Certification must be signed by both a healthcare provider and the insured person subject to the Philadelphia Code certification penalties.

Exemption from religion: An insured person must apply for exemption from religion by confirming in writing that their sincere religious beliefs exclude them from the vaccination. The certification must be signed by the person subject to the Philadelphia Code certification penalties.

The city’s requirements set a “floor” to determine whether an exception applies. Employers are free to adopt adjustment procedures, including review or certification steps, that conform to ADA and Title VII.


When an insured person properly requests an exemption, the institution must take one or more of the following necessary precautions:

  1. Routine check. For healthcare, PCR or antigen testing twice a week; for higher education, PCR tests once a week or antigen tests twice a week.
  2. Masking and distancing. Only for higher education institutions where 90% or more of the insured persons are fully vaccinated, exempt persons must wear a double mask indoors and remain at least 1.80 m away from others at all times, whether on campus or off campus, the one carries out an activity related to higher education.
  3. Virtual accommodations. If possible, an insured person can contact a university or health institution, either remotely or in some other way, so that the person is no longer considered an insured person.

In addition, all individuals must continue to wear face masks or other face covering that complies with the city’s Emergency Ordinance of June 15, 2021 introducing safety measures for the full reopening to prevent the spread of COVID-19.

As with the exemption criteria, the city’s guidelines set a “lower limit” for what an employee who is accommodated on the basis of an exemption must do. Employers are free to choose that these precautions are insufficient to maintain a safe work environment and to impose additional restrictions in accordance with ADA and Title VII.


Healthcare and higher education institutions must document documentation of the vaccination status of each insured person, any exemptions requested, whether each exemption request was granted or denied and why, and the accommodation (s) granted to each exempted person.

Ballard Spahr’s work and employment team is ready to assist employers who wish to introduce a mandatory vaccination program that complies with the city’s Emergency Ordinance.