The hospital called her belief a 'personal moral choice' - one judge disagreed
A children's hospital nurse lost her religious exemption fight over a mandatory COVID-19 vaccine - and one judge says the court got it wrong.
The Ninth Circuit on October 2, 2026 sided with Oregon Health and Science University (OHSU) in a case testing whether an employer's exemption process can lawfully exclude certain religious beliefs.
The nurse had worked in OHSU's Doernbecher Children's Hospital since 2012, caring for newborns, pregnant mothers, and cancer patients. When Oregon's Governor issued Executive Order No. 21-29 in August 2021 requiring healthcare workers to be vaccinated by October 18, 2021, she sought a religious exemption citing her belief that the sanctity of life conflicted with "any requirement to inject abortion derived cell lines into [her] body."
OHSU had already signaled where it stood. An email to exemption applicants listed beliefs that would not qualify - including fetal cell objections and claims of "bodily integrity or sanctity." The hospital called these "personal moral choices and/or conscientious objections rather than a tenet of a religious faith."
The committee denied her. She was fired on December 2, 2021.
She sued on two tracks: a Free Exercise claim against individual board and committee members, and a Title VII failure to accommodate claim against OHSU.
The Free Exercise claim failed on qualified immunity - no law in 2021 recognized a healthcare worker's right to a vaccine exemption on fetal cell grounds during a pandemic.
The Title VII claim failed on undue hardship. Under Groff v. DeJoy (2023), which requires "substantial increased costs," OHSU's evidence held up. An unvaccinated nurse treating immunocompromised newborns and cancer patients posed real health and safety risks. The unit was already short-staffed.
She did not contest the hardship evidence on appeal, arguing pretext - that the denial targeted her beliefs, not operational burden. The court found no basis for importing pretext into the undue hardship analysis.
Then there was the dissent. One judge called the policy "a classic case of the State targeting religious beliefs" and warned it would let employers recast any conviction as a mere "personal moral choice." The majority countered that precedent protected practices like wearing a hijab or keeping a Sabbath - but nothing comparable existed for fetal cell vaccine objections.
Six circuits have now backed healthcare employers on vaccine mandate undue hardship. For HR teams fielding religious accommodation requests, the takeaway is practical: the defence holds when the evidence ties to the employer's operations and patient risk.
