Fifth Circuit Solidifies the “No-State-Action” Rule for Private Employer Vaccine Mandates:
A Comprehensive Commentary on Bridges v. Methodist Hospital, No. 24-20483 (5th Cir. 2025)

1. Introduction

In Bridges v. Methodist Hospital, the United States Court of Appeals for the Fifth Circuit confronted—for the second time in four years—the clash between private-sector COVID-19 vaccination requirements and constitutional claims brought by employees who resisted those requirements. More than 100 former employees of Houston Methodist Hospital System alleged that their terminations for refusing COVID-19 vaccination violated rights secured by 42 U.S.C. § 1983, the Emergency Use Authorization statute (21 U.S.C. § 360bbb-3), and Texas law. They also sued the Chairman of the Texas Workforce Commission (TWC) for denying unemployment benefits to at least one plaintiff.

At the heart of the case lay two pivotal questions:

1. Does a private hospital become a state actor under § 1983 merely because it participated in the federal CDC COVID-19 Vaccination Program and mandated vaccination for its own workforce?
2. Does the EUA statute provide an implied private right allowing employees to sue their employer for requiring vaccination?

The Fifth Circuit answered both questions in the negative, affirmed dismissal with prejudice, and in doing so crystallized a bright-line rule: private employers’ COVID-19 vaccine mandates, even when the employer is also a government-cooperating vaccine provider, do not constitute state action under § 1983, and the EUA statute does not confer a private cause of action against employers.

2. Summary of the Judgment

The Court (Judges Higginbotham, Jones, and Southwick, per curiam) affirmed the district court’s Rule 12(b)(6) dismissal of all federal claims and the denial of leave to amend. Key holdings include:

• No State Action: Applying Pearson v. Shriners Hospitals for Children (5th Cir. 2025), the Court held that Houston Methodist’s employee-vaccination policy is private conduct, not attributable to the State under any of the recognized four “state-action” tests (public-function, compulsion, joint-action, or entwinement).
• No Implied EUA Right: The EUA statute regulates vaccine providers; it does not grant employees a private right of action against employers that mandate vaccination.
• Claims Against TWC Chairman Forfeited: Plaintiffs’ cursory appellate briefing abandoned any meaningful challenge to the dismissal of claims against Chairman Bryan Daniel.
• Dismissal with Prejudice Proper: Plaintiffs had already amended twice and failed to articulate how another amendment would cure the legal deficiencies.

3. Analysis

3.1 Precedents Cited

The Court drew heavily on prior Fifth Circuit and Supreme Court authority regarding state action and implied rights:

• Pearson v. Shriners Hospitals for Children, 133 F.4th 433 (5th Cir. 2025) – dispositive precedent denying § 1983 relief to employees fired under a private hospital’s vaccine mandate.
• Manhattan Community Access Corp. v. Halleck, 587 U.S. 802 (2019) – restates the limited circumstances in which private entities may be deemed state actors.
• Brentwood Academy v. Tennessee Secondary School Athletic Ass’n, 531 U.S. 288 (2001) – source of the “entwinement” test.
• Blum v. Yaretsky, 457 U.S. 991 (1982) – emphasizes that a private nursing home’s decisions are not necessarily state action.
• Section 1983 Baselines: Resident Council of Allen Parkway Village (5th Cir. 1993); Cornish v. Correctional Services Corp. (5th Cir. 2005).
• Pleading Standards: Ashcroft v. Iqbal, 556 U.S. 662 (2009).

The Court viewed Pearson as virtually on all fours: both cases involved private-sector hospitals, CDC Program participation, and identical § 1983 theories. Consequently, Pearson dictated affirmance.

3.2 Legal Reasoning

3.2.1 State Action Inquiry

To sue under § 1983, plaintiffs must show (a) the violation of a federal right, and (b) that the violator acted under color of state law. The Court systematically rejected each applicable state-action pathway:

1. Traditional Public Function: Operating a hospital or issuing workplace mandates is not an exclusive governmental function.
2. Government Compulsion: No statute or regulation compelled Houston Methodist to impose a mandate; the CDC Program imposed conditions on vaccine administration, not employment.
3. Joint Action / Symbiotic Relationship: Plaintiffs alleged no cooperative decision-making between Methodist and government officials regarding employee discipline.
4. Entwinement: Mere participation in a federally orchestrated vaccine-distribution scheme does not entwine the State in the hospital’s HR policies.

Thus, the policy remained private conduct outside § 1983.

3.2.2 EUA Statute

Section 360bbb-3(e)(1)(A)(ii)(III) directs vaccine providers to inform recipients of their option to refuse an EUA-authorized product. The Fifth Circuit reiterated that:

“The provision ‘does not apply at all’ to a hospital ‘acting in its role as a private employer.’” – Bridges, slip op. at 9 (quoting Pearson)

Because the employees did not allege that Methodist administered the vaccine to them, the statute was inapposite. The Court therefore declined to decide whether the statute ever creates an implied remedy.

3.2.3 Claims Against the TWC Chairman

On appeal, plaintiffs offered only perfunctory references to constitutional violations related to unemployment-benefit denials. The Court treated the arguments as forfeited for inadequate briefing, noting potential sovereign-immunity concerns left unaddressed.

3.2.4 Denial of Leave to Amend

Federal Rule 15 favors amendment, but not where amendment would be futile or where plaintiffs had ample prior chances. Here, plaintiffs had already filed two amended complaints yet never sought to add facts resolving the dispositive legal gap—absence of state action. The district court’s refusal to offer a third bite was not an abuse of discretion.

3.3 Likely Impact of the Decision

• Consolidation of Fifth Circuit Doctrine: Bridges and Pearson now stand as a tandem effectively foreclosing § 1983 claims premised on vaccine mandates by private healthcare employers in the circuit.
• Broader EUA Litigation: By again declining to recognize—and indeed casting doubt upon—any implied EUA private right, the Court casts a long shadow over similar claims nationwide.
• Employment-Law Stability: Employers within the Fifth Circuit (Texas, Louisiana, Mississippi) retain wide latitude to impose health-and-safety mandates without risk of being deemed state actors.
• Strategic Shifts for Plaintiffs: Employees challenging mandates must turn to statutory labor-employment frameworks (e.g., Title VII religious-accommodation claims) rather than constitutional theories.
• Judicial Economy: Courts may dispose of copy-cat suits at the pleading stage by straightforward application of Bridges/Pearson.

4. Complex Concepts Simplified

State Action

For constitutional claims against a private entity, plaintiffs must show the conduct is fairly attributable to the State – a high bar met only in narrow scenarios such as when the private party performs a function exclusively reserved to government, or is coerced/controlled by government.

42 U.S.C. § 1983

The primary statute enabling individuals to sue for violations of federal rights by state actors. It is not itself a source of rights; it provides the vehicle for enforcement.

Emergency Use Authorization (EUA)

A mechanism under federal law allowing the FDA to permit use of unapproved medical products in emergencies. It imposes informed-consent duties on those who administer the product, not on employers generally.

Implied Private Right of Action

A judicially recognized right to sue, inferred from a statute’s language and structure, even though Congress did not expressly authorize suits. Courts are reluctant to infer such rights absent clear evidence of congressional intent.

Sovereign Immunity

The constitutional principle that states and state officials (in official capacity) cannot be sued for damages unless immunity is waived or overridden by Congress.

5. Conclusion

Bridges v. Methodist Hospital cements a clear, pragmatic rule in the Fifth Circuit: a private employer’s COVID-19 vaccine requirement—even when the employer partners with government to distribute vaccines—does not convert the employer into a state actor. Coupled with Pearson, the decision nearly forecloses § 1983 or EUA-based challenges to private-sector vaccine mandates in the circuit. Looking forward, plaintiffs opposed to health-related workplace requirements will need to rely on traditional employment statutes rather than constitutional shortcuts. For courts, Bridges provides a template for expeditious dismissal, thereby promoting judicial efficiency and doctrinal clarity in the post-pandemic litigation landscape.