COVID-19 Vaccination Self-Certification Tool

Wednesday, August 11, 2021, 2:45pm

TO: All Employees
FR: Jeff Banks, Senior Associate Vice President for University Personnel and Kendall Newman, Operations Manager for Risk Management on behalf of COVID Monitoring Team

The COVID Monitoring Team, in conjunction with Human Resources, has developed the COVID-19 Vaccination Self-Certification Tool for employees to report their full COVID-19 vaccination under the current agreements with the collective bargaining units. As a reminder, employees of the California State University system will be required to have a COVID-19 vaccination beginning September 30, 2021. More information on the COVID-19 vaccine requirements can be found on the COVID-19 website

This tool is only to be completed if an employee is fully vaccinated. “Fully vaccinated” means you have received, at least 14 days prior, either the second dose in a two-dose COVID-19 vaccine series or a single-dose COVID-19 vaccine. Vaccines must be FDA approved; have an emergency use authorization from the FDA; or, for persons fully vaccinated outside the United States, be listed for emergency use by the World Health Organization (WHO). Unvaccinated persons (or persons who choose not to provide their vaccination status) should not complete the self-certification. 

You will not be required to provide proof of vaccination at this time. An exception to this is that employees who work in certain departments will be required to provide proof of vaccination under local and state public health orders. We will be following up with those specific employees in a separate communication to provide detailed information. 

Information submitted through this portal is confidential. Only members of the COVID Monitoring Team and Human Resources will have access to the information provided. 

Exemptions to the vaccine requirement: Details will be provided soon on how employees can apply for an exemption to the vaccine requirement for medical or religious reasons.

Requirements by Bargaining Unit: 

  • Managers, confidential staff, and non-represented members: All non-represented employees are required to complete the COVID-19 Vaccination Self-Certification if they are fully vaccinated. This includes managers, confidential staff, and special consultants. 
  • California State University Employee Union (Units 2, 5, 7, and 9), California Faculty Association (Unit 3), Teamsters Local 2010 (Unit 6), and Statewide University Police Association (Unit 8): Members are welcome to certify they are fully vaccinated using the COVID-19 Vaccination Self-Certification Tool.
  • Union of American Physicians and Dentists (Unit 1), Academic Professionals of California (Unit 4), and Academic Student Employees (Unit 11): Members are welcome to certify that they are fully vaccinated using the COVID-19 Vaccination Self-Certification Tool, however, the unions have not yet agreed to the CSU Vaccine Verification Program. 

If you are unclear of your classification or representation status, please contact the COVID Monitoring Team or Human Resources. 

If you have any questions, please contact the COVID Monitoring Team at