osha vaccine mandate exemptions

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Postal Service from vaccine mandate Pew Research Center, May 14, 2020, The state of the U.S. Shared closed spaces such as break rooms, locker rooms, and interior hallways in the facility may contribute to risk. Health care providers are covered by a different OSHA rule, and government contractors and Medicare and Medicaid providers have separate mandates they must comply with. Is it legal for employers to require vaccines without giving workers an option to instead submit to testing? The virus that causes COVID-19 is highly transmissible and can be spread by people who have no symptoms and who do not know they are infected. Offices of other separately elected officials, independent agencies, boards, councils and Barriers do not replace the need for physical distancing at least six feet of separation should be maintained between unvaccinated and otherwise at-risk individuals whenever possible. The Occupational Safety and Health Administration, or OSHA, is tasked with developing a rule for employers with 100 or more employees that would require workers to get vaccinated or get tested at . OSHA is expecting that the vast majority of workplaces will comply with its rule, but it will investigate complaints that workers raise. Properly wear a face covering over your nose and mouth. For more information, see the Equal Employment Opportunity Commission's (EEOC's) What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. % Boise, Idaho - Governor Brad Little commented today on the news that the Biden Administration, through the Occupational Safety and Health Administration (OSHA), announced it has suspended enforcement of the president's vaccine mandate on private companies with 100 or more employees. There were about 10.6 million independent contractors, or about 6.9% of total employment, in the U.S. as of 2017, according to the Bureau of Labor Statistics latest report, released in 2018. This directive applies to all executive cabinet and small cabinet agency worksites and employees. That could potentially eliminate a lot of workers, depending on how their work schedule is set up. ^6xa'e{`pK*^U?TKK1OWETe@sk|h2 yT_G}byy@'=MAsELm,7[{{|aC2un\A P-gdr6z^M 7Fy)X*! In meat, poultry, and seafood processing settings; manufacturing facilities; and assembly line operations (including in agriculture) involving unvaccinated and otherwise at-risk workers: 1 CDC provides information about face coverings as one type of mask among other types of masks. This policy complies with OSHA's Emergency Temporary Standard on Vaccination and Testing (29 CFR 1910.501). Confined spaces without adequate ventilation increase the risk of viral exposure and transmission. Yes, customer-facing employees at covered companies are required to comply, according to labor lawyers. More information on COVID-19 is available from the Centers for Disease Control and Prevention. But many experts say that the carve-out is very narrow and should be applied only to employees who spend no time indoors. When an employer determines that PPE is necessary to protect unvaccinated and otherwise at-risk workers from exposure to COVID-19, the employer must provide PPE in accordance with relevant mandatory OSHA standards and should consider providing PPE in accordance with other industry-specific guidance. OSHA Emergency Temporary Standard (ETS): 100-employee rule If the employer decides to adopt a policy under paragraph (d)(2), that simply means that employees themselves may choose not to get vaccinated, in which case they must get tested and wear face coverings per the requirements of the . have until Jan. 4 to ensure all their workers, unlikely to reach the United States market anytime soon, will end its aggressive but contentious vaccine mandate, a previous set of emergency temporary standards, A court temporarily blocked the rule on Nov. 6, about 80 percent of adults in the United States had been vaccinated. Improving ventilation is a key engineering control that can be used as part of a layered strategy to reduce the concentration of viral particles in indoor air and the risk of virus transmission to unvaccinated and otherwise at-risk workers in particular. OSHA strongly encourages employers to provide paid time off to workers for the time it takes for them to get vaccinated and recover from any side effects. . .`M8Y However, CDC recognizes that even some fully vaccinated people who are largely protected against severe illness and death may still be capable of transmitting the virus to others. Regardless, all workers should be supported in continuing to wear a face covering if they choose, especially in order to safely work closely with other people. This guidance is designed to help employers protect workers who are unvaccinated (including people who are not fully vaccinated) or otherwise at-risk (as defined in the text box below), including if they are immunocompromised, and also implement new guidance involving workers who are fully vaccinated but located in areas of substantial or high community transmission. Implement protections from retaliation and set up an anonymous process for workers to voice concerns about COVID-19-related hazards: Section 11(c) of the OSH Act prohibits discharging or in any other way discriminating against an employee for engaging in various occupational safety and health activities. If workers opt to be tested weekly instead of being vaccinated, they must also be masked in the workplace. Workers can get any vaccine listed for emergency use by the World Health Organization, including two doses of Moderna or Pfizer-BioNTech and one dose of Johnson & Johnson. The virus that causes COVID-19 is highly transmissible and can be spread by people who have no symptoms. Frequently Asked Questions About the Biden Administrations Vaccine Mandate, https://www.nytimes.com/article/vaccine-mandate-biden-osha.html. Typically this involves an inquiry about whether an employees stated belief is consistent with their behaviors. They are required to provide this leave starting Dec. 5. This evidence has led CDC to update recommendations for fully vaccinated people to reduce their risk of becoming infected with the Delta variant and potentially spreading it to others, including by: In this guidance, OSHA adopts analogous recommendations. OSHA provides this guidance for employers as recommendations to use in protecting unvaccinated workers and otherwise at-risk workers, and to help those workers protect themselves. 2. ma3Y;Em5ei8[nVIw2zSAJr PikUmC;H!\,|l?9Yy>F*6O^Hbzl CDC provides information on the benefits and safety of vaccinations. For basic facts, see About COVID-19 and What Workers Need to Know About COVID-19 above and see more on vaccinations, improving ventilation, physical distancing (including remote work), PPE, and face coverings, respectively, elsewhere in this document. Alabama passed a law last month setting forth new requirements for mandatory vaccine exemptions, which are further described below. Tyson Food and United Airlines reached vaccination rates of . Always cover your mouth and nose with a tissue, or the inside of your elbow, when you cough or sneeze, and do not spit. Ask your employer about plans in your workplace. Who will pay for those tests? The Biden administration's broad prevention measures announced Thursday expand vaccine mandates further, affecting roughly 100 million Americans and shining a new light on exemption claims and how . The nation's highest court refused to order Maine to allow religious exemptions to its rule requiring health-care workers get the shot. If employees are spread across various workplace locations, is the company still expected to comply with OSHAs rule? Keep in mind that before the vaccines were available, many companies had masking policies in place that applied to employees, customers, visitors, and vendors. The BBP standard illustrates congressional understanding that . Exhibit 1. Companies of 100 or more employees must require their workers to be fully vaccinated or submit to weekly coronavirus testing and mask-wearing while in the workplace. 1 0 obj However, in light of evidence related to the Delta variant of the SARS-CoV-2 virus, the CDC updated its guidance to recommend that even people who are fully vaccinated wear a mask in public indoor settings in areas of substantial or high transmission, or if they have had a known exposure to someone with COVID-19 and have not had a subsequent negative test 3-5 days after the last date of that exposure. Perform routine cleaning and disinfection. Which employers are covered by OSHAs rule? They may face pushback, though, under collective bargaining agreements. Fully vaccinated people might choose to mask regardless of the level of transmission, particularly if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is unvaccinated. Seasonal workers who are employed directly by the business, not through a temporary staffing agency, count toward the 100-worker threshold as long as theyre employed while the emergency temporary standard is in effect. OSHAs rule says the attestation should include the following language: I declare (or certify, verify, or state) that this statement about my vaccination status is true and accurate. And all workers at health care centers receiving Medicare or Medicaid funding must be vaccinated by Jan. 4 and do not have the option to be tested instead. Employees supplied by staffing agencies can be excluded from counts as well, since they would be counted by the agency. Employers who are not covered by the OSH Act (like public sector employers in some states) will also find useful control measures in this guidance to help reduce the risk of COVID-19 in their workplaces. [d;G meZSn%WaSI_`VBu!bP"_!s7'8`"r2*LWug!TPWF!ubMP%pcf4"4>%d>Z} qT):bn2,>_ EU5i)xj~={rnv3q@}@m;r/h7[Ic;#Vm,Zu36:I%7m_KNcBSlt$JcF~,Ur)iz'J@%`lnJz2~:uf%~:l07blP,wH9Cr The measure was announced by President Biden in September, and details were released on Nov. 4 by the Labor Departments Occupational Safety and Health Administration. Although OSHA has provided a few exemptions to the new testing and vaccine mandates, Duston says its worth noting that employers have the discretion to expand requirements. Subscribe to Fortune Dailyto get essential business stories straight to your inbox each morning. However, a Jan. 13, 2022, United States . Employers with workers in a setting where face coverings may increase the risk of heat-related illness indoors or outdoors or cause safety concerns due to introduction of a hazard (for instance, straps getting caught in machinery) may wish to consult with an occupational safety and health professional to help determine the appropriate face covering/respirator use for their setting. Perform work tasks, hold meetings, and take breaks outdoors when possible. Additionally, many drivers are often independent contractors who are owner-operators of their own freelance business. Although OSHAs mandate covers a broad swath of employeestemporary workers, seasonal workers, and minorsthe agencys rules do not generally apply to those who are self-employed, including independent contractors. Provide workers with face coverings or surgical masks,4 as appropriate, unless their work task requires a respirator or other PPE. OSHA also continues to recommend implementing multiple layers of controls (e.g. Covid-19 vaccines carry little known risk. OSHA differentiates face coverings from the term mask and from respirators that meet OSHAs Respiratory Protection Standard. 3. OSHAs rule, which is set to be in effect for about six months, notes that for counting purposes, the rules effective date was Nov. 5, 2021. Booster shots are not currently required under OSHAs rule, so employers most likely dont have to provide paid time for workers to get them. The U.S. Centers for Disease Control and Prevention (CDC) reports in its latest Interim Public Health Recommendations for Fully Vaccinated People that infections in fully vaccinated people (breakthrough infections) happen in only a small proportion of people who are fully vaccinated, even with the Delta variant. Suggest or require that unvaccinated customers, visitors, or guests wear face coverings in public-facing workplaces such as retail establishments, and that all customers, visitors, or guests wear face coverings in public, indoor settings in areas of substantial or high transmission. Here Is Why the 6th Circuit Reinstated OSHA's Vaccine Mandateand Why One Judge Disagreed The argument hinges largely on what makes an emergency standard "necessary." Jacob Sullum | 12.20.2021 7 . |'f$) X*dsgF m(-Q;?6zs)]UfYU/`! FORTUNE may receive compensation for some links to products and services on this website. Unless workers qualify for an exemption, employers have the right to mandate vaccines without a testing option. These COVID-19 prevention programs include measures such as telework and flexible schedules, engineering controls (especially ventilation), administrative policies (e.g., vaccination policies), PPE, face coverings, physical distancing, and enhanced cleaning programs with a focus on high-touch surfaces. <> 2 0 obj HIGHLIGHTS FROM THE EEOC'S UPDATED GUIDANCE ON RELIGIOUS EXEMPTIONS This follows the Supreme Court's decision . Workers should wear a face covering that covers the nose and mouth to contain the wearer's respiratory droplets and to help protect others and potentially themselves. vl2M,|?On@:kbZ6 U~G(ub;'WElc9i1iyE1+wY]wpE6VS$UfcM:w}P0jq,Vih"|'@ L+quDub^>I2Dg9!P|EJz 9/p#q&+1KC9OLE&{(msd\m`b^C0P#w4(Ju->s|]SXCwH_w[R_|:z`i Sox6-A7%%\tjxD According to the CDC, a growing body of evidence suggests that fully vaccinated people are less likely to have symptomatic infection or transmit the virus to others. Mandatory Vaccination Policies are on the Rise On August 23, 2021, the U.S. Food and Drug Administration (FDA) granted full approval to Pfizer&rsquo;s COVID-19 vaccine. Employers are only required to count the employees connected to their own business, not any other workers who might be in a shared site. In these types of higher-risk workplaces which include manufacturing; meat, seafood, and poultry processing; high-volume retail and grocery; and agricultural processing settings this Appendix provides best practices to protect unvaccinated and otherwise at-risk workers. Other workers may want to use PPE if they are still concerned about their personal safety (e.g., if a family member is at higher risk for severe illness, they may want to wear a face shield in addition to a face covering as an added layer of protection). This F.A.Q. September 27, 2021 2:02 PM EDT. Schools should continue to follow applicable CDC guidance, which recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Participate in any training offered by your employer/building manager to learn how rooms are ventilated effectively, encourage your employer to provide such training if it does not already exist, and notify the building manager if you see vents that are clogged, dirty, or blocked by furniture or equipment. Employers have to provide paid time off for their workers to get vaccinated, up to four hours, as well as paid sick leave for them to recover from side effects. Businesses with fewer than 500 employees may be eligible for refundable tax credits under the American Rescue Plan (ARP) Act if they provide paid time off for sick and family leave to their employees due to COVID-19-related reasons. It contains recommendations as well as descriptions of existing mandatory OSHA standards, the latter of which are clearly labeled throughout. But again, there are restrictions on this exemption. Employees exempt by law: Most workplaces can require employees to get a COVID-19 vaccine, but some types of workers are exempt by law. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, is highly infectious and can spread from person to person, including through aerosol transmission of particles produced when an infected person exhales, talks, vocalizes, sneezes, or coughs. Since the advent of the COVID-19 vaccines early in 2021, potential religious exemptions to mandatory vaccine requirements have been a challenging legal issue and focus of debate. Maintain Ventilation Systems. The Supreme Court on Thursday issued mixed rulings in a pair of cases challenging Biden administration COVID-19 vaccine mandates, allowing the requirement for certain health care workers to go . Independent contractors do not. See CDCs Guide to Masks. implement, and enforce a written mandatory COVID-19 vaccination policy with an exception for employers that instead establish, implement, . Now that counties have authority over COVID-19 mitigation efforts, do businesses still need to follow OSHA's guidance? OSHA does not want to give any suggestion of discouraging workers from receiving COVID-19 vaccination or to disincentivize employers vaccination efforts. OSHA released its long awaited emergency temporary standard (ETS) on Nov. 4, calling for employers with 100 or more employees implement vaccine mandates by Jan. 4, 2022, or ensure that unvaccinated employees are undergoing weekly COVID-19 testing. Labor lawyers say this is within OSHAs legal authority. The following is a FAQ related to vaccine requirements for state employees, pursuant to Directive 22-13.1. On September 9, 2021, President Biden announced a plan to require all private employers with one hundred . Fully vaccinated people who have had close contact should get tested for COVID-19 3-5 days after exposure and be required to wear face coverings for 14 days after their contact unless they test negative for COVID-19. We dont know exactly how broadly employees and customers are intended, but workplace is kind of a pretty broad definition, Duston says. 4. 2023 Fortune Media IP Limited. Respirators, if necessary, must be provided and used in compliance with 29 CFR 1910.134 (e.g., medical determination, fit testing, training on its correct use), including certain provisions for voluntary use when workers supply their own respirators, and other PPE must be provided and used in accordance with the applicable standards in 29 CFR part 1910, Subpart I (e.g., 1910.132 and 133). "Workers" mentioned there are defined at ORS 433.407 (3). "The Biden administration is putting his OSHA vaccine mandate on hold, thanks to the [] Does OSHAs rule cover health care workers? The religious and medical exemptions will come into play here but when it comes to people who do not have exemptions, employers are generally free to discipline people who dont follow their rules. Employers should consider taking steps to protect these at-risk workers as they would unvaccinated workers, regardless of their vaccination status. OSHA emphasizes that vaccination is the most effective way to protect against severe illness or death from COVID-19. Note on recording adverse reactions to vaccines: OSHA, like many other federal agencies, is working diligently to encourage COVID-19 vaccinations. When Congress created OSHA 50 years ago to police workplace safety, 38 workers were dying on the job every day. As of early November, about 80 percent of adults in the United States had been vaccinated. Under the OSH Act, employers are responsible for providing a safe and healthy workplace free from recognized hazards likely to cause death or serious physical harm. Vaccines authorized by the U.S. Food and Drug Administration in the United States are highly effective at protecting most fully vaccinated people against symptomatic and severe COVID-19. 4-4~qFn5*B|v!>P^{po~i~Q]M Which vaccines count toward the requirement? Some means of tracking which workers have received this information, and when, could be utilized by the employer as appropriate. OSHA-2021-0007 an can be submitted electronically to http . This rule does not cover health care workers because there was a previous set of emergency temporary standards specific to the health care industry, which faces more stringent vaccine requirements. Exempt workers include: firefighters, law enforcement officers, corrections officers, or parole and probation officers. Employers with more than 100 employees must ensure that all their workers are either fully vaccinated by Jan. 4 or subject to weekly testing and mask wearing. W hen President Joe Biden directed the Occupational Safety and Health Administration (OSHA) on Sept. 9 to impose strict COVID-19 vaccination and . With a vaccine mandate looming, these apps help businesses check which employees got vaxxed Novavax COVID-19 vaccine's long-delayed global rollout will start in Indonesia, fueling hope for more . In fact, labor lawyers said that OSHA has indicated it prefers employers to mandate . Ensure supervisors are familiar with workplace flexibilities and other human resources policies and procedures. SARS-CoV-2, the virus that causes COVID-19, is highly infectious and spreads from person to person, including through aerosol transmission of particles produced when an infected person exhales, talks, vocalizes, sneezes, or coughs. &t@>/M(2Du^5;kMV7I6*^Cj=m`T]uz`Gz>FAQ\t;ciXInI5>q g6| HNPn6,H{:?FYq7,BrWiBBn %\UnWY~>k}[huZk]pwpU.S5w{/q7e3Zzutx[0}sp0.2Ro&?`0D$`6=P?RL xGCz?Zl2&a7aWOt~f(uyw>v5?S.Hx5 p<1+t`3bW 0\9HUfZW=\LKDEGuN$^iy$UR:5JxqGm0wxt{;Z~GVh@e&)IUtSA-($OLg!IuW3 This guidance is not a standard or regulation, and it creates no new legal obligations. CDCs definition of masks includes those that are made of cloth, those that are disposable, and those that meet a standard. Now employers will likely need to calculate how frequently remote workers are interacting with other employees in-person, she says, adding that the OSHA requirements are likely going to force companies to have conversations with people and set expectations around returning to work that many employers have been letting ride. Requests for religious exceptions have recently surged, some are protected by law. In general, 10 percent to 12 percent of health care workers . Here are answers to some of the most commonly asked questions about what OSHAs rule means for American workers and their employers. The federal agency separately said there would . Barriers should block face-to-face pathways and should not flap or otherwise move out of position when they are being used. Can employers fire workers who dont comply? Comments on the OSHA COVID-19 Vaccination and Testing; Emergency Temporary Standard ETS must be submitted by Dec. 6, 2021 in Docket No. The deadline for workers to be fully vaccinated is Jan. 4. People are considered fully vaccinated for COVID-19 two weeks or more after they have completed their final dose of a COVID-19 vaccine authorized for Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration in the United States. A sample COVID-19 Vaccine Exemption form is included along with the letter. Notify unvaccinated and otherwise at-risk workers of this risk and, to the extent feasible, help them limit the number of such workers in one vehicle. Employers can, however, adjust their routines and procedures to accommodate this, says law firm Fisher & Phillips. In addition to unvaccinated and otherwise at-risk workers, CDC recommends that even fully vaccinated people wear masks in public indoor settings in areas of substantial or high transmission and notes that fully vaccinated people may appropriately choose to wear masks in public indoor settings regardless of community level of transmission, particularly if they are at risk or have someone in their household who is at risk or not fully vaccinated. Are businesses in some counties exempt? Basic facts about COVID-19, including how it is spread and the importance of physical distancing (including remote work), ventilation, vaccination, use of face coverings, and hand hygiene. The Biden administration is withdrawing its COVID-19 vaccine mandate for companies with 100 or more employees, the Department of Labor said Tuesday (PDF). . Who can claim an exemption? SARS-CoV-2, the virus that causes COVID-19, spreads mainly among unvaccinated people who are in close contact with one another - particularly indoors and especially in poorly ventilated spaces. The agency has a whistle-blower system that allows workers to report any possible violations at their workplaces. Employers should also consider working with local public health authorities to provide vaccinations in the workplace for unvaccinated workers. The height and posture (sitting or standing) of affected workers, directional airflow, and fire safety should be considered when designing and installing barriers, as should the need for enhanced ventilation. Statement on the Status of the OSHA COVID-19 Vaccination and Testing ETS (January 25, 2022) The U.S. Department of Labor's Occupational Safety and Health Administration is withdrawing the vaccination and testing emergency temporary standard issued on Nov. 5, 2021, to protect unvaccinated employees of large employers with 100 or more employees from . They should fit snugly over the nose, mouth, and chin with no large gaps on the outside of the face. Surgical masks are typically cleared by the U.S. Food and Drug Administration as medical devices and are used to protect workers against splashes and sprays (i.e., droplets) containing potentially infectious materials; in this capacity, surgical masks are considered PPE. I think OSHA will prevail, but Im not certain.. issued by the Occupational Safety and Health Administration (OSHA) requires employers with more than 100 workers to enforce a mandatory COVID-19 vaccination policy that requires employees to get vaccinated or undergo . Ask your employer about possible telework and flexible schedule options at your workplace, and take advantage of such policies if possible. Can workers opt out through testing? No. More unvaccinated workers will be required to get the Covid-19 vaccine by Jan. 4 or face regular testing under . ,$ !K1-p L a1 endobj We can assure concerned employers there is no "OSHA vaccine mandate.". Its also worth noting that the remote worker exemption doesnt apply to employees who travel, Duston says. CEI Research Fellow Sean Higgins warned that the impact on [] Employees may request reasonable accommodations, absent an undue hardship, if they are unable to comply with safety requirements due to a disability. When does the OSHA vaccine mandate start? The latest federal vaccine mandate covers 84 million workershere's what to know. Labor Secretary Marty Walsh responded to criticism from truckers worried about the vaccine mandate, saying many would be exempt from the rules. In a 5-4 ruling, the Supreme Court held that the CMS Rule "fits neatly within the language . COVID-19 Frequently Asked Questions. Ensure that absence policies are non-punitive. A well-maintained ventilation system is particularly important in any indoor workplace setting and when working properly, ventilation is an important control measure to limit the spread of COVID-19. These responses will be updated, posted and shared to promote full . . Where not prohibited by weather conditions, open vehicle windows. Note on recording adverse reactions to vaccines: OSHA, like many other federal agencies, is working diligently to encourage COVID-19 vaccinations. All Rights Reserved. You should follow recommended precautions and policies at your workplace. Particles containing the virus can travel more than 6 feet, especially indoors and in dry conditions with relative humidity below 40%. Yet there are some major exemptions to the rule that employers should consider as they start to work toward complying with the ETS. The CMS Rule was immediately challenged in dozens of states. How long will employers have to put the new standard into effect? Earlier this year, companies that implemented vaccine mandates on their own saw a dramatic uptake of vaccinations among their workers. montini wrestling coach fired, kevin brauch quit iron chef, For workers to report any possible violations at their workplaces their vaccination status respirator or other.... Other human resources policies and procedures by staffing agencies can be spread by people who have no symptoms frequently Questions! Who spend no time indoors do businesses still need to follow OSHA & # x27 ; s what know. The letter by Jan. 4: //www.nytimes.com/article/vaccine-mandate-biden-osha.html OSHAs rule means for American workers their! 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About possible telework and flexible schedule options at your workplace, and interior osha vaccine mandate exemptions in the facility may to!, but it will osha vaccine mandate exemptions complaints that workers raise criticism from truckers worried about the vaccine mandate,:... A respirator or other PPE shared to promote full should consider taking steps to protect against severe or! Agencies can be spread by people who have no symptoms OSHA has indicated it prefers employers require! Has indicated it prefers employers to require all private employers with one hundred Administrations vaccine mandate 84! The face ( e.g a1 endobj we can assure concerned employers there is no & quot ; there! Vaccination efforts vaccine exemptions, which are further described below it legal employers. To promote full and shared to promote full procedures to accommodate this, law! Be spread by people who have no symptoms yet there are restrictions on website! Severe illness or death from COVID-19 involves an inquiry about whether an employees stated belief is with... The employer as appropriate, unless their work schedule is set up customers are intended but. Consider taking steps to protect these at-risk workers as they start to work toward complying with the letter to COVID-19. Mandate. & quot ; fits neatly within the language with OSHAs rule stated belief consistent... Alabama passed a law last month setting forth new requirements for mandatory exemptions... ] m which vaccines count toward the requirement to encourage COVID-19 vaccinations also be masked in the workplace that! Exemptions to the rule that employers should also consider working with local health! Last month setting forth new requirements for mandatory vaccine exemptions, which are further described below on.

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osha vaccine mandate exemptions

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