WASHINGTON (AP) — With just weeks remaining before federal workers must be vaccinated against COVID-19, the federal government on Monday outlined procedures for employees to request medical or religious exemptions from President Joe Biden’s mandate.

The Office of Management and Budget released the new guidance Monday afternoon ahead of the Nov. 22 deadline for workers to be fully vaccinated, outlining specific medical conditions that would warrant an exemption. Under the guidelines, agencies are to direct workers to get their first shot within two weeks of an exemption request being denied, or the resolution of a medical condition. They also make clear that federal agencies may deny medical or religious exemptions if they determine that no other safety protocol is adequate.

The Biden administration is drawing on Centers for Disease Control and Prevention guidance to determine approved medical exemptions, including a history of allergic reaction to the vaccines. Other conditions, including being treated with monoclonal antibodies or having a history of multisystem inflammatory syndrome, warrant a 90-day delay in vaccination, in accordance with CDC advice.

While the CDC recommends that women who are pregnant or are planning to become pregnant get vaccinated against COVID-19, the federal government will consider requests to delay vaccination while pregnant depending on the worker’s particular medical circumstances.

Senior administration officials provided The Associated Press with a preview of the new guidance Monday before it was posted by OMB.

Federal workers seeking exemptions will engage in what officials called an “interactive process” with their agencies, which will include being asked to provide documentation to support the exemption and potential accommodations. In the event an exemption request is rejected, workers will have two weeks to get a first shot, or be subject to disciplinary proceedings in accordance with Biden’s order.

Unvaccinated workers are required to wear masks and maintain social distancing and will have their ability to travel for work curtailed. New testing guidance for those who are granted exemptions is expected to be unveiled in the coming weeks.

In some cases, agencies may deny even legitimate exemption requests if they determine “that no safety protocol other than vaccination is adequate” given the nature of the employee’s job.

Under CDC guidelines, people are only considered fully vaccinated two weeks after their second dose of two-shot mRNA vaccines from Pfizer and Moderna or the one-dose Johnson & Johnson shot — meaning most federal workers have until Nov. 8, at the latest, to roll up their sleeves to comply with Biden’s order.

According to the new federal guidance, neither past COVID-19 infection nor an antibody test can be substituted for vaccination.

Meanwhile, private companies with more than 100 employees will be subject to a forthcoming rule from the Occupational Safety and Health Administration requiring all employees to be vaccinated or get tested weekly. Biden announced the regulation weeks ago, but the agency is still drafting the particulars.

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