Gartner Research

Implementing Vaccine and Testing Mandates in the U.S.

Published: 15 November 2021


U.S. organizations may be required to ensure their employees are vaccinated against COVID-19 or tested weekly under a new federal regulation set to go into effect on 4 January 2022. HR leaders can use this benchmarking data to inform their strategies for enforcing vaccine and testing mandates.

Although 80% of U.S. adults have received at least one dose of a COVID-19 vaccine, 30% of adults and over 40% of the total U.S. population are not yet fully vaccinated. In July, President Joe Biden announced a vaccine requirement for all federal executive branch workers and employees of contractors that do business with the federal government. The Biden administration will also require all private-sector employers with 100 or more employees to ensure their workers are either vaccinated or tested weekly.

On 4 November, the administration announced that this mandate would come into effect on 4 January 2022.The new rule from the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) will also require that these employers provide paid leave for employees to get vaccinated and ensure all unvaccinated workers wear a face mask in the workplace. The rule is expected to affect 84 million employees throughout the U.S.

At least 26 states filed lawsuits challenging the mandate shortly after the details were announced. On 6 November, a federal appeals court issued an order temporarily blocking the mandate: a decision it affirmed and extended on 12 November. The Biden administration maintains that OSHA has the authority to implement a vaccine mandate and has encouraged employers to proceed with preparing to enforce it, but the outcome remains uncertain.

If the new rule survives judicial review, companies implementing these vaccination and testing requirements will need to make several decisions across three stages:

The vast majority of U.S. employers we surveyed either have implemented or intend to implement vaccine or testing requirements in accordance with the federal mandate. In a Gartner benchmarking survey conducted on 27 October, only 5% of executive leaders said their organizations did not plan or were not required to implement a vaccine mandate. However, many employers have not yet made key decisions about how to implement the mandate.

The first decision organizations need to plan for is what option, or combination of options, they can offer employees to comply with the government’s directives. For instance, 42% of executive leaders said their organizationhad implemented or was planning to implement a vaccine mandate, requiring all employees to be vaccinated. Twenty-four percent said their organization would allow employees to either get vaccinated or get tested, and 28% said they hadn’t decided yet(see Figure 1). Comparing these figures to the results of a previous benchmarking survey conducted on 29 September, organizations appear to be moving toward vaccine mandates and away from the testing option.

Figure 1. Response to the U.S. Government’s New Vaccine/Testing Requirements

The other key decisions for organizations stem from the potential challenges leaders foresee in implementing the mandates, most commonly employee resistance and turnover (see Figure 2).

Figure 2. Challenges Associated With Implementing Vaccine/Testing Mandates

As they plan whether and how to mandate vaccines, organizations will need to take the following matters into consideration:

  • Applicability of Laws and Regulations — Companies will need to ascertain the specific laws or rules that are applicable to them. For instance, in the case of workers on federal contracts, vaccination is the only option, while for others, a weekly COVID-19 test is an alternative to mandatory vaccination.

  • Impact of Local and State Laws or RestrictionsSome state governments have rejected the Biden administration’s vaccine and testing rules and have implemented their own rules restricting or altogether banning companies from mandating vaccines. Several states have banned vaccine mandates for employees of state agencies, schools and healthcare institutions.

  • Impact on TalentOrganizations will need to consider the effect of a vaccine mandate on their employees and employer brand. A vaccine mandate may push some employees to quit, and employees who do not comply may be terminated. Companies with employee unions will need to discuss their mandate plans with labor representatives.

  • Financial ImpactA vaccine mandate will also involve certain additional costs, including technology or administrative costs for vaccination tracking, or the costs of hiring temporary workers or contracting with vendors.

  • Liability ConcernsCompanies will also need to ascertain their legal and medical liability in cases where vaccination leads to severe complications or side effects for an employee. Companies that are considering offering on-site vaccination for their own staff should check with their legal team to ensure that they do not incur additional liability by providing vaccines directly.

In the October survey, when asked about the actions their organizations had already taken to implement the new vaccine/testing requirements:

  • 48% of executive leaders said their organization had stepped up efforts to encourage vaccination among employees.

  • 39% said they had consulted medical and legal experts on vaccination and testing policies.

  • 50% said they had already communicated the implications of the new policy to employees.

Comparing these answers to the September survey, we see a greater emphasis on communicating with employees, both about the implications of the new government policy and about the organization’s process and policies regarding vaccination and testing (see Figure 3).

Figure 3. Actions Taken by Organizations to Implement the U.S. Government’s Vaccine/Testing Requirements

HR leaders implementing vaccine mandates will need to carefully consider both how they design the process and how they communicate the mandate to employees and other stakeholders.

To design a clear and effective vaccine mandate policy and verification process, organizations should consider these questions:

  • Which employees will be covered under the vaccine mandate?

  • Where will employee data about vaccination status be stored, and will it be deleted later?

  • How will we manage employees who have been partially vaccinated?

  • What action will be taken against employees who refuse to be vaccinated?

Religious and other exemptions — Some of the most common questions organizations have are about the criteria for determining whether an employee is exempt from a vaccine mandate, whether for religious, medical or other reasons.

Our October benchmarking survey found that on average, executive leaders anticipate that 8.1% of their employees will be eligible or apply for exemptions. Twenty-seven percent said they had not yet decided their criteria for exemptions, while 51% said they would follow government directives on exemptions, but these directives may not always be straightforward, especially when federal, state and local policies are not aligned.

Testing protocols — Many organizations plan to give employees the option to be tested for COVID-19 regularly if they choose not to get vaccinated (and some states’ policies require this option). However, our survey indicates that more than half of organizations are unsure of how to manage employee testing for COVID-19 (see Figure 4). In designing a testing policy, organizations will need to answer the following questions:

  • What types of tests will be allowed in case an employee refuses to be vaccinated?

  • Will the company provide a testing facility on-site, or will employees need to get tested themselves?

  • Who will pay for testing?

  • If employees get tested themselves, will the employee be required to submit proof of a negative test result or just report the test result?

  • Will the company select a vendor for COVID-19 testing of employees?

  • Should employees who are awaiting test results stop working or work remotely in the meantime?

  • Will employees who have received only one dose of the vaccine be tested on a weekly basis?

Figure 4. Organizations’ Plans to Manage Employee Testing

It is critical for organizations to be clear about the mandate’s requirements. The communication should clearly articulate the organization’s expectations of employees, the role of each stakeholder involved and the point of contact for any questions. The following points should be kept in mind while framing the communication strategy:

  • Clearly communicate mandate requirements and deadlines.

  • Create an FAQ document that answers the most common questions employees may have.

  • Enforce two-way communication between employees and management.

  • Enable managers to hold meetings with employees about the mandate.

  • Communicate frequently to provide timely information about any updates and changes to the mandate based on evolving government directives.

It is also important to decide which team or group of people will own the mandate implementation process and to ensure they are aware of their responsibilities.

Organizations that implement a vaccine mandate will also need to monitor employee compliance. This will entail tracking employees’ vaccination status, validating proof of vaccination or eligibility for exemptions, and (where applicable) tracking test results for employees who opt for regular testing instead of vaccination.

Vaccination Status TrackingMore than 90% of executive leaders said their organizations planned to track the vaccination status of employees, using methods ranging from asking for a physical or digital copy of a vaccine certificate to asking employees to self-report (see Figure 5). Half of respondents said their organizations would have employees upload documentation through an internal HR system.

Figure 5. Organizations’ Plans to Validate Employee Vaccination Status

As they make plans to track employees’ vaccination status, HR leaders should consider:

  • How will the organization maintain records of employees’ vaccination status?

  • Is there a need to track whether employees have received booster shots?

  • Will the vaccination status of all employees be tracked or only those who visit the work site?

  • How long will the organization retain vaccination information, and how will it ensure employee health data remains secure and private?

Validating Vaccination Status Organizations should consider the following questions about validating proof of vaccination:

  • Who will validate the proof submitted by the employee? (e.g., HR, business manager, third-party vendor)

  • What action will be taken against employees who falsify proof of vaccination or exemption?

In our September survey, 59% of executive leaders said their organizationswould terminate employees who falsified their vaccination status.

Finally, organizations need to decide how to respond to employees who refuse to comply with vaccine mandates. In October, 34% of leaders said their organizations would terminate employees who refused to get vaccinated, but 38% have still not decided how to handle these situations (see Figure 6). HR leaders will need to work closely with their organization’s legal team to make sure their policies for those who refuse vaccines are consistent with state and local regulations.

Figure 6. Plans for Responding to Employees Who Refuse Vaccination

In addition to these considerations, HR leaders need to plan for potential workforce attrition as a result of the vaccine mandate. Turnover has been a major source of anxiety for HR leaders over the past six months. On average, the executive leaders we surveyed anticipate 6.4% turnover due to the mandate, including employees who quit instead of getting vaccinated and those who are terminated for refusing to comply.

Recommended by the Authors


COVID-19 Vaccinations in the United States, U.S. Centers for Disease Control and Prevention.

Path Out of the Pandemic, The White House.

Gartner Managing Employee Vaccination and Workplace Reopening Webinar Poll (27 October 2021). This survey was conducted during a webinar with over 250 executive leaders (function heads and business unit leaders) on the line from across a wide spectrum of industries. A large majority were based in North America, though the perspectives and practices they shared were developed to support their global organizations.

Gartner Reopening the Workplace, Vaccination and Retention Strategies (29 September 2021). This survey was conducted during a webinar with over 250 executive leaders (function heads and business unit leaders) on the line from across a wide spectrum of industries. A large majority were based in North America, though the perspectives and practices they shared were developed to support their global organizations.


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