How is the public sector handling requests for medical or religious exemptions from the COVID-19 vaccine? There are variations in the approach, but judging by the numbers so far, the process seems rigorous — as it should be.

The government institutions with the longest history of dealing with immunization laws are the public and private schools and universities, but these statutes also apply to any adult educational school as well as preschools and child care centers.

What is unusual is that a pandemic has forced many people who haven’t dealt with vaccination rules since school days to confront the issue again.

It was encouraging to see that 95 Hawaii pastors, representing dozens of churches, have signed an open letter in support of vaccinations, published in Thursday’s Honolulu Star-Advertiser. This can help dispense with the notion that a generic religious argument can be made against vaccinations.

A state report issued this week noted that only 87 state government workers have applied for vaccination or testing exemptions.

However, state and county department heads now implementing a new COVID-19 policy for their employees, as well as private employers with a vaccine mandate, still face a challenging job making a determination on individual cases.

Fortunately, supervisors evaluating exemption petitions statewide are taking direction from the state Department of Human Resources Development, which on Aug. 12 issued formal guidance. The attestation form a petitioner submits for a medical exemption requires a medical provider to affirm the worker’s condition precludes vaccination.

The religious exception should require the employee to demonstrate that the belief is “sincerely held” and qualifies as a religion and how it prevents him or her from getting a shot, according to the guidance.

As an example, the UH religious exemption application involves attaching one of three documents: a statement discussing “the nature and tenets” of the belief; written materials describing the religious belief regarding vaccines; or a written statement from the religious organization’s leader on the subject.

This is not an insurmountable hurdle by any means, but it does require that a petitioner for a religious exemption give it serious thought and make a real effort. And that will produce a healthier outcome for us all.