Tina Wise v. Children's Hosp. Med. Ctr. of Akron

• Court: Court of Appeals for the Sixth Circuit
• Decided: May 14, 2025
• Docket: 24-3674
• Status: Unpublished

Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 25a0246n.06

No. 24-3674

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT FILED May 14, 2025 KELLY L. STEPHENS, Clerk ) TINA WISE, ) Plaintiff-Appellant, ) ON APPEAL FROM THE ) UNITED STATES DISTRICT v. ) COURT FOR THE NORTHERN ) DISTRICT OF OHIO CHILDREN’S HOSPITAL MEDICAL ) CENTER OF AKRON, ) OPINION Defendant-Appellee. ) ) )

Before: CLAY, READLER, and DAVIS, Circuit Judges

CLAY, Circuit Judge. Plaintiff Tina Wise was terminated by her employer, Defendant

Children’s Hospital Medical Center of Akron, for failing to adhere to Defendant’s COVID-19

testing and vaccination policies. Plaintiff subsequently brought suit against Defendant, alleging

religious discrimination for failure to accommodate and retaliation, in violation of Title VII of the

Civil Rights Act of 1964, 42 U.S.C. § 2000e, et seq. The district court granted summary judgment

in favor of Defendant, which Plaintiff now appeals. For the reasons that follow, we AFFIRM the

district court’s judgment.

I. BACKGROUND

A. Factual History

Defendant is a pediatric hospital located in Akron, Ohio. Defendant employed Plaintiff as

a staff pharmacist, where Plaintiff worked from April 12, 1999, to June 14, 2022. No. 24-3674, Wise v. Child.’s Hosp. Med. Ctr.

Plaintiff abstains from receiving vaccines. She received her last vaccine in 1990, and

developed religious reservations towards vaccines in the early 2000’s. It is her belief that “any

medical intervention should only be used to cure illness or alleviate suffering and not performed

on a healthy person.” Wise Dep., R. 22-1, Page ID #243. Starting in 2013, Defendant exempted

Plaintiff from receiving the flu vaccine.

The issue in this case centers on disease testing during the COVID-19 pandemic. COVID-

19 proved to be particularly problematic for Defendant, as its young patients—especially children

who were under the age of one or had compromised immune systems—fell into the high-risk

category. Additionally, because many of Defendant’s employees contracted the virus, Defendant

faced significant staffing constraints. To reduce the effects of COVID-19, Defendant implemented

a wide range of policies to limit the virus’ spread. One such policy was the Related Employment

Requirements Program, which required employees to either receive a COVID-19 vaccine or

undergo regular testing. Defendant mandated employee participation in this program due to the

age and immunocompromised status of many of Defendant’s patients. The policy was later

updated to require all employees to receive the vaccine, unless an employee submitted a religious

or medical exemption request.

Plaintiff applied for an exemption to the policy, requesting that she be exempted from both

the vaccine and testing requirements. She specifically wrote:

I have long believed that any medical intervention should only be used to cure illness or alleviate suffering and not [be] performed on a healthy person. . . . Therefore, not only vaccinating myself for a potential future illness shows a misplaced trust and lack of faith in my God (as stated originally), but also subjecting myself to medical interventions, like the invasive COVID-19 intranasal testing, when I have no illness to cure and am in no need of alleviation from suffering, violates these deeply established beliefs.

R. 22-7, Page ID #371.

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Defendant approved the request for the vaccine exemption. However, Defendant denied

the testing exemption request, stating:

The federal mandate requires health care providers such as [Defendant] to implement procedures that mitigate the spread of COVID-19 by unvaccinated staff members. Testing unvaccinated staff members who come onsite is the best way to accomplish this.

Regardless of whether the testing requirement actually conflicts with a sincerely held religious belief, to exempt unvaccinated staff members who work onsite from the COVID-19 testing requirement would constitute an undue hardship. Your request is therefore denied.

R. 25-8, Page ID #1089. There were three primary reasons why Defendant believed that granting

the testing exemption would cause undue hardship. First, Defendant was concerned about keeping

its patient population safe. Second, there was a risk that by approving Plaintiff’s request,

Defendant would have to approve similar requests and thus increase the risk of spreading the virus.

Third and finally, Defendant had an obligation under federal rules to institute mitigating efforts

that reduced the risk posed by those employees who were approved for vaccine exemptions.

In February 2022, Plaintiff tested positive for COVID-19. Defendant’s policy granted an

unvaccinated employee a 90-day reprieve from testing if the employee tested positive for COVID.

Plaintiff was therefore exempt from COVID-19 testing for the following 90 days. However, when

her 90-day period expired, Plaintiff refused to resume testing. Plaintiff received two written

warnings from Defendant: the first on June 1, 2022, and the second on June 6, 2022. After Plaintiff

refused to meet Defendant’s testing requirements, Defendant terminated Plaintiff’s employment

on June 14, 2022.

B. Procedural History

On November 18, 2022, Plaintiff filed a complaint in the U.S. District Court for the

Northern District of Ohio, alleging that Defendant violated Title VII of the Civil Rights Act of

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1964, 42 U.S.C. § 2000e, et seq. She specifically alleged that Defendant’s decision to fire Plaintiff

because of her refusal to test constituted religious discrimination on both failure-to-accommodate

and retaliation grounds. Defendant subsequently moved for summary judgment. The district court

granted the motion, finding that Defendant had sufficiently demonstrated “that granting Plaintiff’s

testing exemption would have caused an undue hardship.” Order, R. 33, Page ID #1221. Plaintiff

now appeals the district court’s determination.

II. DISCUSSION

A. Standard of Review

“We review a district court order granting summary judgment under a de novo standard of

review, without deference to the decision of the lower court.” Rose v. State Farm Fire & Cas. Co.,

766 F.3d 532, 535 (6th Cir. 2014) (citation and quotation marks omitted). Under Federal Rule of

Civil Procedure 56(a), summary judgment is proper “if the movant shows that there is no genuine

dispute as to any material fact and the movant is entitled to judgment as a matter of law.” “A

dispute of a material fact is genuine so long as the evidence is such that a reasonable jury could

return a verdict for the non-moving party.” Kirilenko-Ison v. Bd. of Educ. of Danville Indep. Schs.,

974 F.3d 652, 660 (6th Cir. 2020) (cleaned up). “When evaluating a motion for summary

judgment, this Court views the evidence in the light most favorable to the party opposing the

motion.” Id. (citing Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986)).

“This includes drawing all justifiable inferences in the nonmoving party’s favor.” Id. (citation and

quotation marks omitted).

B. Analysis

Where a plaintiff employee establishes a prima facie case of religious discrimination, “the

burden shifts to the defendant employer to show that it could not reasonably accommodate the

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employee without undue hardship.” Virts v. Consol. Freightways Corp. of Delaware, 285 F.3d

508, 516 (6th Cir. 2002). “The reasonableness of an employer’s attempt to accommodate is

determined on a case-by-case basis.” Cooper v. Oak Rubber Co., 15 F.3d 1375, 1378 (6th Cir.

1994). To evaluate whether an employer could reasonably accommodate an employee, the

Supreme Court has explained that “[w]hat is most important is that ‘undue hardship’ in Title VII

means what it says, and courts should resolve whether a hardship would be substantial in the

context of an employer’s business in the commonsense manner that it would use in applying any

such test.” Groff v. DeJoy, 600 U.S. 447, 471 (2023). This Court has clarified that “an employer

does not have to actually experience the hardship in order for the hardship to be recognized as too

great to be reasonable.” Virts, 285 F.3d at 519.

The district court did not reach the question of whether Plaintiff had established a prima

facie case of religious discrimination. Instead, the district court proceeded to an undue hardship

analysis, assuming arguendo that Plaintiff had met the prima facie elements. The district court

ultimately concluded that “allowing the plaintiff to routinely come in for work at the Hospital

while remaining unvaccinated and untested creates a heightened health risk that constitutes as an

undue hardship.” Order, R. 33, Page ID #1221. Accordingly, the district court held that Defendant

had met the undue hardship burden and granted summary judgment in Defendant’s favor on both

Title VII claims. The district court’s determination was without error.

Defendant has provided sufficient evidence to meet the undue hardship standard.

Defendant’s primary service is pediatric care, which necessarily involves caring for a particularly

vulnerable population. As one of Defendant’s physicians noted in his deposition, “viruses occupy

. . . a very significant portion of pediatric illness,” as “children are . . . highly vulnerable to

infection.” Brower Tr., R. 23-1, Page ID #453. The physician further noted that “children always

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become a concern whenever we’re dealing with any infectious scenario, especially one that we’re

not familiar with, and we’re waiting for things to develop. So yes, children . . . will always remain

a concern when we’re talking about an infection, an infectious risk, because they are more

vulnerable.” Id. at Page ID #455. Furthermore, many of the children that Defendant treats fall

into the most vulnerable categories of hospital patients: NICU babies, children with cancer, and

children with compromised immune systems. Defendant provided testimony that to protect these

vulnerable patients during the pandemic, one of its top priorities was “caring for and keeping its

pediatric patient population safe.” Larimore Decl., R. 26-1, Page ID #1131. To accomplish this,

Defendant relied on both vaccinations and testing. The reason Defendant relied on testing was

because without the assurance that an employee was COVID-negative, Defendant would have no

way to ensure that infected individuals did not come into contact with vulnerable patients.

The general concerns regarding COVID-19 are more acute when viewed in the context of

Plaintiff’s specific role at the hospital. Plaintiff was exposed to up to 27 pharmacy employees

each ten-hour shift, some of whom also worked on the hospital’s patient floors. Plaintiff’s shifts

also overlapped with nearly every other pharmacy shift, and Plaintiff herself described the

pharmacy as “contained.” Wise Tr., 22-1, Page ID #176–178, 281. Viewed as a whole, the

evidence paints a clear picture. Defendant cares for children—a category of individuals who are

in-and-of-themselves an at-risk population. Many of these patients, such as children with cancer

or NICU babies, are particularly vulnerable. To protect these individuals, the hospital took

straightforward measures to ensure that the virus would not spread. And Plaintiff is precisely the

kind of person who could easily spread the virus: she worked in a contained area, with a large

number of people, for ten hours a day. Without regular testing, Defendant would have no way of

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verifying whether this highly exposed employee was spreading an extremely transmissible virus

to at-risk patients.

This case is nearly identical to a case recently decided by this Court, Kizer v. St. Jude

Child.’s Rsch. Hosp., No. 24-5207, 2024 WL 4816856 (6th Cir. Nov. 18, 2024). Much like

Plaintiff in this case, the plaintiff in Kizer worked at a children’s hospital and held religious

objections to vaccinations. Id. at *1. The hospital mandated that all employees receive a COVID-

19 vaccine because the hospital primarily treated “vulnerable pediatric patients.” Id. The plaintiff

applied for a religious exemption to the vaccine mandate, which the hospital denied “because her

job required her to work in person in clinical areas and in contact with clinical people.” Id. The

plaintiff then brought suit under Title VII, alleging religious discrimination. Id. This Court

affirmed the district court’s grant of summary judgment, finding that the hospital could not

accommodate the plaintiff without sustaining undue hardship. Id. at *3–8. Relevant to this case,

the Court specifically noted that the hospital “presented evidence that to allow unvaccinated

individuals to work on campus would pose a safety risk to the hospital’s vulnerable juvenile

patients (who were largely immunocompromised and unable to be vaccinated).” Id. at *6.

The factual similarities between this case and Kizer are apparent. Both Plaintiff and the

plaintiff in Kizer worked in a children’s hospital. And both Defendant and the hospital-defendant

in Kizer did not accommodate religious exemptions because of the unique vulnerabilities of their

child patients. Furthermore, the hospital-defendant in Kizer did not provide the option of either

receiving the vaccine or undergoing regular testing; instead, the hospital mandated vaccines. Id.

at *1, *6. Thus, Defendant in this case was given even more leeway by her employer than the

plaintiff in Kizer.

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Other circuits have reached similar conclusions as Kizer. In Melino v. Boston Medical

Center, the First Circuit considered a case where a hospital implemented a COVID-19 vaccine

requirement. 127 F.4th 391, 395 (1st Cir. 2025). The plaintiff in Melino requested a religious

exemption to the mandate, which the hospital denied. Id. The First Circuit affirmed the district

court’s grant of summary judgment in favor of the hospital, finding that the hospital had

sufficiently demonstrated undue hardship. Id. at 397–98. The hospital argued that allowing the

plaintiff “to work unvaccinated would pose an undue hardship ‘by increasing the risk of COVID-

19 transmission amongst staff and patients.’” Id. at 397. Although the plaintiff’s argument against

undue burden turned only on whether “the vaccines worked”—a claim the First Circuit rejected

because the hospital demonstrated that it relied on guidance from the Centers for Disease Control

and Prevention, which stated that vaccines mitigate against “the effects and spread of COVID-

19”—that opinion reveals why a more broad-based argument would also likely to have failed: the

plaintiff worked in “COVID-19 units” treating “the overwhelming influx of seriously ill patients

infected with the COVID-19 virus.” Id. at 394, 397–98. In other words, that hospital, like

Defendant here, faced an “increased risk of [employees] spreading the virus” to “medically

vulnerable” patients. Id. at 394.

Both Kizer and Melino paint a clear picture. Hospitals facing the pressures of the pandemic

faced immense pressure to keep their patients safe. And where a hospital presents evidence that

accommodating an employee’s exemption would threaten the hospital’s most vulnerable

patients—as is the case here—such exemptions constitute undue hardship.

Plaintiff provides a number of arguments in support of her contention that the district court

erred. None are persuasive. First, Plaintiff argues that Defendant has only outlined hypothetical

risks and has not identified any concrete harms that have materialized from lack of testing. But

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this Court has noted that it is not required that an employer show a materialized harm in order to

meet the undue hardship standard. See DePriest v. Dep’t of Hum. Servs., No. 86-5920, 1987 WL

44454, at *4 (6th Cir. Oct. 1, 1987) (per curiam). Furthermore, there was no evidence in Kizer

that the defendant-hospital had sustained a concrete harm due to unvaccinated employees. Kizer,

2024 WL 4816856 at *1, *6. And this Court has previously held that “safety considerations are

highly relevant in determining whether a proposed accommodation would produce an undue

hardship on the employer’s business. Title VII does not require that safety be subordinated to the

religious beliefs of an employee.” Draper v. U.S. Pipe & Foundry Co., 527 F.2d 515, 521 (6th

Cir. 1975).

Second, Plaintiff contends that Defendant’s policies were inconsistent and that the

evidence fails to demonstrate that non-tested employees posed a risk to the hospital. Plaintiff

notes, for example, that vaccinated employees were not required to take tests (despite their

continued susceptibility to the virus) and that Plaintiff was not required to take a test for 90 days

following her COVID-19 diagnosis (despite still posing a risk due to the infection). Yet as

Defendant points out, the hospital’s decision-making process was heavily influenced by the

fluctuating recommendations of the scientific community, the changes in government rules and

guidelines, and the development and availability of key resources. What Plaintiff asks, in essence,

is for this Court to critically review the hospital’s decision-making and determine whether those

decisions were thoroughly consistent. That suggestion would require the Court to substitute the

health and safety judgment of a hospital facing a rapidly evolving, highly uncertain novel

pandemic for that of the Court’s own hindsight judgment. Plaintiff does not point to, and we

cannot identify, case law that permits the Court to engage in such Monday morning

quarterbacking.

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Third, Plaintiff asserts that Defendant “failed to provide evidence that accommodating Ms.

Wise would cause staffing problems or lead to negative cumulative effects.” Appellant Br., ECF

No. 17, 21. Yet Defendant counters this argument by providing evidence to the contrary. For

example, Defendant states that allowing Plaintiff to remain unvaccinated and untested would have

resulted in staffing shortages. The logic of this argument is persuasive. Without a means to verify

that Plaintiff was free of the virus, the hospital risked allowing an infected employee to enter a

workspace that was both highly confined and filled with other employees. That would necessarily

greatly increase the risk of spreading the virus within the workspace, thus resulting in staffing

shortages. And if such staffing shortages continued, they would have profound effects on the

hospital. During the height of the pandemic, for example, reduced staffing required Defendant to

call in employees outside their normal working hours, shift employees from other locations to the

central pharmacy, and employ the services of temporary staffing agencies. It is foreseeable that

such problems would continue if Defendant allowed employees to remain unvaccinated and

untested.

Additionally, Defendant notes that at least 35 other employees had requested the same

religious exemption as Plaintiff, which would have “exponentially increased” the risk of spreading

the virus throughout the hospital. Appellee Br. 37, ECF No. 20 (quoting Reihs Tr., R. 25-1, Page

ID #1026–27) (alteration adopted). Again, Defendant’s logic is persuasive. Without the

verification of testing, one employee alone could cause the virus to spread rapidly throughout the

hospital. But when multiplied across 35 employees, that risk necessarily grows at an exponential

rate.

Taken as a whole, Defendant has presented a convincing case as to why it would face an

undue hardship in accommodating Plaintiff. The hospital cares for particularly vulnerable patients

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whose lives could be placed at risk if they were to contract the virus. It was thus paramount that

Defendant take the highest precautions to ensure the safety of those patients. Verifying that

employees were free of COVID-19, either through vaccination or testing, was an essential means

by which Defendant could ensure that its employees were not spreading the virus to vulnerable

patients. It would have therefore been an undue hardship for the hospital to accommodate

Plaintiff’s request to be exempt from both testing and vaccination. Defendant offers no convincing

argument to the contrary, and this finding is directly in line with this Court’s holding in Kizer.

Considering that a finding of undue hardship is sufficient for Defendant to prevail in this matter,

see Virts, 285 F.3d at 516, Plaintiff’s argument fails.

III. CONCLUSION

For the reasons set forth above, this Court AFFIRMS the judgment of the district court.

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