New York’s vaccine mandate today has two main pieces: a longstanding requirement that children be immunized to attend school or daycare, and a set of Department of Health rules requiring healthcare workers to be immune to measles and rubella. The COVID-19 mandates that once covered healthcare staff and New York City public employees have been rescinded or allowed to expire, though private employers can still require vaccination as a condition of employment. A December 2025 U.S. Supreme Court action has also put the state’s school-vaccine law back in play on religious-exemption grounds.
School and Daycare Vaccines
Every child entering a public, private, or parochial school in New York must be immunized before attending, and the same rule applies to daycare, nursery school, Head Start, and pre-kindergarten programs. Public Health Law Section 2164 lists the required vaccines: polio, mumps, measles, diphtheria, rubella, varicella, hepatitis B, pertussis, tetanus, Haemophilus influenzae type b (Hib), and pneumococcal disease. Students entering sixth grade need a Tdap booster, and students entering seventh and twelfth grades need meningococcal doses.1New York State Senate. New York Public Health Law 2164 – Immunization Requirements The Department of Health’s regulations line these requirements up with the federal Advisory Committee on Immunization Practices (ACIP) schedule.2New York State Department of Health. Immunization Laws and Regulations
A child who has started a vaccine series but not finished it can attend school “in process” as long as the family is on track with the ACIP catch-up schedule. If a child falls behind and misses a scheduled dose, the school has to exclude that student within 14 calendar days of the missed interval.3New York State Education Department. Immunization Guidelines for Schools
Student Exemptions Are Medical Only
In June 2019, the legislature repealed the religious exemption from school immunization requirements. Senate Bill S2994A, enacted as Chapter 35 of the Laws of 2019, struck subdivision 9 of Section 2164 entirely.4New York State Senate. New York State Senate Bill S2994A Since then, the only available exemption for students has been medical.
A medical exemption requires a licensed New York physician to complete DOH form 5077, identifying the specific vaccine that is contraindicated, the reason, and whether the contraindication is permanent or temporary. The physician’s reasoning must be consistent with ACIP guidance or another nationally recognized standard of care.5New York State Department of Health. Immunization Requirements for School Attendance Medical Exemption Statement Schools review these forms and can refer questionable exemptions to the Department of Health for a second look.6New York State Department of Health. Medical Exemption Review Procedures for Schools Outside New York City
The religious-exemption picture may not stay settled. In December 2025, the U.S. Supreme Court vacated the Second Circuit’s decision upholding New York’s no-religious-exemption rule and sent the case back for reconsideration in light of Mahmoud v. Taylor, a 2025 ruling that recognized a parental First Amendment right to opt children out of public school programs that conflict with religious beliefs. The Supreme Court’s order does not restore religious exemptions in New York on its own, and the Second Circuit could reach the same result on different reasoning. But the door that closed in 2019 is at least ajar again, and families and schools should watch the remand.
Healthcare Worker Requirements
Healthcare workers face their own rules, separate from the school mandate. Department of Health regulations require all personnel at hospitals, nursing homes, diagnostic and treatment centers, home health agencies, and hospices to be immune to measles and rubella.2New York State Department of Health. Immunization Laws and Regulations “Personnel” is defined broadly and includes paid employees, contract staff, students, and volunteers.
Facilities that don’t enforce those requirements face civil penalties under Public Health Law Section 12, with a baseline fine of up to $2,000 per violation and up to $5,000 for certain repeat or serious violations.7New York State Senate. New York Public Health Law 12 – Penalties
The COVID-19 Rule Is No Longer in Effect
The regulation that generated the most litigation, 10 NYCRR 2.61, required all personnel at covered healthcare entities to be vaccinated against COVID-19.8New York State Department of Health. 10 NYCRR 2.61 – Prevention of COVID-19 Transmission by Covered Entities It is no longer active, and recent New York court decisions refer to it as “former 10 NYCRR 2.61.”9New York State Unified Court System. Banasik v Mount Sinai Health System The federal CMS COVID-19 vaccination requirement for Medicare- and Medicaid-certified facilities also ended, effective August 5, 2023.10Centers for Medicare and Medicaid Services. Revised Guidance for Staff Vaccination Requirements
Individual hospitals and health systems can still require COVID-19 vaccination through their own internal policies, and many in New York continue to do so.
Private Employers and Vaccines
Outside healthcare, no current state or city mandate requires private-sector workers to be vaccinated against any disease. New York City lifted its private-sector COVID-19 vaccine requirement in early 2023, returning the decision to individual employers.
New York is an at-will employment state, and employers can generally set health-related conditions of employment. A private company can require vaccination as workplace policy, and an employee who refuses without an approved exemption can be terminated. The policy has to be applied consistently, cannot target protected classes, and has to leave room for the exemption process described below. The practical question for most private-sector employees is not whether the employer can require the shot but whether the employer handles exemption requests properly when they come in.
Religious and Medical Exemptions at Work
Both federal and New York law protect employees who ask for an exemption based on disability or a sincerely held religious belief. The processes look similar; the legal frameworks are different.
Medical Exemptions
An employee with a medical condition that prevents vaccination can request a reasonable accommodation under the Americans with Disabilities Act or under New York Executive Law Section 296. The employee supplies documentation from a physician identifying the contraindication, and the employer enters an interactive process to see whether an accommodation such as masking, testing, or reassignment would let the employee keep working without imposing undue hardship on the business. Under state law, undue hardship for disability accommodations takes into account the overall size of the business, the type of operation, and the nature and cost of the accommodation.11New York State Senate. New York Executive Law 296 – Unlawful Discriminatory Practices If no workable accommodation exists, the employer can legally deny the request.
Religious Exemptions
An employee whose sincerely held religious belief conflicts with a vaccine requirement can request an accommodation under Title VII or under Section 296(10) of the New York Executive Law. The employee submits a written explanation of the belief and how it conflicts with vaccination, and the employer must make a genuine effort to accommodate before denying.11New York State Senate. New York Executive Law 296 – Unlawful Discriminatory Practices
The standard for denying a religious accommodation changed in 2023, when the U.S. Supreme Court decided Groff v. DeJoy. The prior rule let employers refuse an accommodation that imposed anything more than a trivial cost. The new rule requires the employer to show that the accommodation would impose a “substantial” burden “in the overall context of an employer’s business.”12Supreme Court of the United States. Groff v. DeJoy Generalized concerns about safety risk or vague cost estimates are no longer enough; the employer has to point to an actual substantial burden tied to the specific accommodation requested.13U.S. Equal Employment Opportunity Commission. What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws
The EEOC has also indicated that the process for evaluating religious accommodation requests should be fair and non-adversarial. Employers who use aggressive questioning panels or attempt to challenge the sincerity of an employee’s beliefs through hostile interrogation risk violating federal anti-discrimination law.14U.S. Equal Employment Opportunity Commission. EEOC Issues Federal Sector Appellate Decision Finding Unlawful Discrimination in Denial of Religious Accommodation to COVID-19 Vaccine Mandate
Unemployment Benefits After a Vaccine-Related Firing
There is no blanket rule on whether unemployment benefits are payable after a firing tied to vaccine refusal. New York evaluates these claims case by case, weighing whether the mandate was legally required, whether a valid exemption request was pending, and whether the employer offered alternatives.
Workers in fields where vaccination was required by law, such as healthcare and education, have the hardest path. Refusing without a valid medical exemption when the law required the shot is likely to be treated as disqualifying misconduct. Public employees who were subject to proof-of-vaccination mandates and refused to comply may also be disqualified. A worker who had a valid religious or medical exemption request that the employer denied without proper accommodation may have a stronger claim, though outcomes depend on the employer’s operational reasoning.
Recent Court and Policy Developments
Three developments matter for anyone still dealing with the fallout from earlier mandates.
Garvey v. City of New York and the Four-Month Clock
Public employees terminated under New York City’s COVID-19 vaccination mandate challenged their firings in Matter of Garvey v. City of New York. A lower court initially sided with the workers, but the Appellate Division, Second Department reversed in 2026, holding that the challenge was time-barred because the employees did not file within four months of receiving their termination notices, as required by CPLR 217(1). The court dismissed the proceeding without reaching the merits.15New York State Unified Court System. Matter of Garvey v City of New York The practical takeaway: if you plan to challenge a government employment action in New York, the four-month clock starts on the final notice, not on the day you decide to fight it.
NYC’s Reinstatement Offer
In November 2025, Mayor Adams offered roughly 1,500 former city employees who had been terminated for refusing the COVID-19 vaccine the opportunity to return to their former titles at the current salary. The offer came without back pay for the years they were out and without credit for the time they did not serve the city.16NYC Mayor’s Office. Mayor Adams Offers Former Employees Who Were Terminated for Refusing COVID-19 Vaccine the Opportunity to Return For workers who were out for about three years, that gap in seniority and lost wages is substantial.
The School-Vaccine Law Goes Back to the Second Circuit
The most consequential pending question is whether New York’s 2019 elimination of religious exemptions for school vaccinations survives constitutional review. After the U.S. Supreme Court vacated the Second Circuit’s ruling in December 2025 and directed reconsideration in light of Mahmoud v. Taylor, the case is back before the appeals court. Religious exemptions are not restored while the remand is pending, and the Second Circuit could still uphold the law on different reasoning. But if the 2019 repeal is ultimately struck down, New York will need to build some form of religious exemption process back into its school immunization system.