COVID-19 Health Order FAQs about vaccination and testing

Get answers to questions about what the COVID-19 Health Order says about vaccination and testing.

NOTE: These FAQs are designed to help answer your questions about the Health Order, but they are not updated as often. So, if there are any differences, follow what the most recent Health Order says.

Vaccination and testing FAQs for COVID-19 health orders

Who must get vaccinated and receive a booster?

It is a requirement for personnel in high-risk settings (like healthcare facilities and jails) to have their initial vaccine series and 1st booster once eligible. Employers must ask anyone who routinely works in a high-risk setting for proof of vaccination.

The requirements for vaccination and booster for employees who routinely work in a high risk-setting such as hospitals, skilled nursing facilities, residential care facilities for the elderly, homeless shelters and jails are specified in local and state health orders. 

What is the booster requirement for workers in high-risk settings who have had COVID-19 infection?

Workers in high-risk settings who were (1) vaccinated with a complete initial series and (2) recently infected with COVID-19 may, upon providing proof such as a lab result or doctor’s note, defer getting boosted for up to 90 days from the date of their first positive COVID-19 test or clinical diagnosis. Any worker with a deferral due to a proven COVID-19 infection must have received their first booster no later than 15 days after the expiration of their deferral.

Additionally, Personnel who routinely work onsite at homeless shelters (other than congregate living health facilities) are no longer required to receive a Booster but are strongly encouraged to do so. 

Personnel who are not permanently stationed or regularly assigned to High-Risk Settings but due to their duties may enter or work in High-Risk Settings on an intermittent or occasional basis or for short periods of time (such as police and lawyers who visit people in the jails) are no longer required to be up-to-date on vaccination, but are strongly encouraged to do so. 

What does it mean to be "up-to-date on vaccination"?

The United States Centers for Disease Control and Prevention (CDC) updated its definition for being up-to-date on vaccination as follows: “You are up to date with your COVID-19 vaccines if you have completed a COVID-19 vaccine primary series and received the most recent booster dose recommended for you by the CDC." Every eligible individual living, working, and visiting San Francisco is strongly urged to get "up-to-date on vaccination" as soon as they are able.

Up-to-date information on booster recommendations and eligibility may be found sf.gov/get-your-covid-19-booster.

Which employees in high-risk settings are exempt from vaccination requirements?

The vaccination requirements apply to all employees in high-risk settings, however there are limited exemptions for religious beliefs and qualifying medical reasons. 

To claim an exemption, workers in high-risk settings must submit a declination form to their employer or the organization operating the high-risk setting. An exemption from vaccination requirement does not extend to the masking - all employees who work in high-risk settings are required to wear a well-fitted mask (except while actively eating or drinking). Use of non-vented N95 masks, supplied by the high-risk setting upon request, is strongly encouraged.

I am an employee who works in a high-risk setting. Does the health order allow my employer to ask me for information concerning my request for an exemption based on a disability or sincere religious belief?

Because the health order prohibits employees from working indoors at high-risk facilities unless they are vaccinated with a complete initial series and have their booster once eligible, the employer can not allow people who are not up-to-date with their vaccination to work in the high-risk setting. If an employee demonstrates a disability or sincere religious belief that prevents them from receiving a COVID-19 vaccine and the employer might be able to provide them with reasonable accommodation. Nothing in the health order is intended to prevent an employer from engaging with its employees to determine whether the employee has a qualifying disability or religious belief or to determine whether the employer can offer the employee a reasonable accommodation.

Last updated October 31, 2022