PIERRE, SD (AP) — South Dakota Senate Republicans on Monday gave warm support to Gov. Kristi Noem’s proposal to allow employees to obtain exemptions from their employer’s COVID-19 vaccination mandates, in l adopting with the required two-thirds majority if it is to be enacted immediately.

The bill drew only four “no” votes in the 35-member Senate, sending it to the House. The proposal would allow employees to qualify for an exemption from their employer’s vaccination requirement by citing either a medical exemption certified by a medical professional, any religious grounds for refusal, or a test showing antibodies to COVID-19 over the past six months.

Noem is pushing for the bill to gain two-thirds support from both houses so it can pass immediately.

The Republican governor has earned a national reputation among conservatives for taking a hands-off approach to the virus. But even Noem has apparently changed his stance on the issue of vaccine mandate exemptions over the past year.

In August she said in a Twitter video that employers should at least allow religious exemptions from warrants, but added that “I don’t have the authority as governor to tell them what to do.”

“It’s not conservative to develop government and tell businesses what to do and how to treat their employees,” Noem said at the time.

However, she became a strong supporter of the mandate-exemption proposal during this year’s legislative session and argued that her current proposal fits her philosophy of hands-off government. His office presented it as a middle ground between health experts who advocate vaccines and those who oppose mandates outright.

As senators debated Noem’s proposal, several raised questions about how a religious exemption can be defined. The bill requires employees to sign a 30-word statement stating that they object to being vaccinated against COVID-19 on religious grounds, but states that these cannot be “social philosophies, political or economic or a simple preference”.

President Joe Biden’s administration pushed last year to increase the country’s vaccination rate against COVID-19 and slow the spread of the coronavirus through employment mandates. But the US Supreme Court stopped that effort.

However, Biden’s demand for millions of health care workers, issued by Medicare and Medicaid providers, remained. Noem’s proposal also provides an exemption for these health care providers, as well as National Guard troops.

Republican Senator Erin Tobin, a certified nurse practitioner, argued for the exemptions and called the vaccine requirements “politically charged.”

“With the latest variant, it’s going to spread and vaccination is really your choice,” she said.

Democrats, who hold just three Senate seats, have offered their opposition, arguing that it undermines efforts by public health experts and companies to get employees vaccinated.

“I think freedom from the virus is important,” said Democratic Senator Reynold Nesiba.

The proposal comes as South Dakota’s 59% fully immunized rate lags behind the national rate of 64%. The state Department of Health reported 259 people hospitalized with COVID-19 on Monday, marking a drop from last month when the number topped 400 — the highest rate in more than a year.

Meanwhile, the House on Monday passed a bill requiring doctors to be able to prescribe ivermectin, an unproven treatment for COVID-19. The drug, which is typically used for parasites, has been promoted by conservative commentators as a treatment despite the lack of conclusive evidence that it helps people with the virus.

Federal health officials saw an increase in prescriptions for the drug last year, accompanied by a worrying increase in reported overdoses.

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