Is it okay to ask health care providers if they are vaccinated?
Recently, I asked my chiropractor if he had received his Covid vaccine. He said no. He and his assistant wear masks, but they see patients in a small room with a closed door. When I asked him again several weeks later, he said, “Well, we have to talk. I’m not going to get the vaccine. I don’t believe in vaccinations. My family and I are all healthy and don’t see the need for it. As I walked out I asked her assistant if she had been vaccinated, and she replied, “No, and I don’t intend to.” It’s a personal decision. I called the next morning to explain to them that I would not be returning to their practice because they were not vaccinated. Later that day the chiropractor called me and asked if I wanted to respect his privacy and not talk to anyone about his decision not to be vaccinated.
I was appalled. Isn’t that an unethical request? He is a health care provider during a pandemic. Shouldn’t his patients know that he chose not to be vaccinated, as recommended by the CDC? Doesn’t his personal decision affect others in potentially dangerous ways? By asking me to hide his decision, doesn’t he make me an accomplice in his duplicity? Name omitted
A number of questions have recently arisen about how to negotiate a social and professional world in which vaccination against Covid-19 is both mainstream and contested. What is clear is that many people think that getting the vaccine is just about protecting yourself. And we have what a philosopher would call a reason for caution in getting vaccinated – a reason that is all the more compelling the older we are. Yet there is also an altruistic and public-inspired reason for getting vaccinated: There is now ample evidence that people who have been vaccinated are much less likely to pass the virus on to others.
When masks were first recommended, medical authorities emphasized their benefits not for the wearer but for others; It was only after a few months and further studies that it was clearly established that the masks were helping both parties. It is the opposite with vaccines. Vaccine approval depended on trials designed to show benefits to recipients, so officials were initially reluctant to say what’s now clear: that they help others too. The larger point is the one I have already raised: when many people accept a small inconvenience – like wearing a mask or getting vaccinated – we can achieve something very valuable for all of us.
Getting vaccinated is more than a good idea. It is an act of civic responsibility.
So clinicians who tell you that vaccination is a ‘personal decision’, as if it doesn’t affect, and therefore doesn’t worry anyone, are making an all too common mistake. Your chiropractor thinks his own family’s current health is all that is relevant, as he doesn’t think he could infect a foreign senior and cause their death. (A CDC study suggests the majority of Covid cases were transmitted by people who weren’t symptomatic at the time.) He’s not very likely to do so at work, of course, assuming that ‘he takes appropriate precautions, including masking and ensuring good ventilation in the small room where he works. Even so, his clients would be even safer if he and his assistant were vaccinated. This is why it is not a personal decision, in the intended sense. Getting vaccinated, for those who have no medical contraindications, is more than a good idea; it’s something we owe each other. It is an act of civic responsibility.
And note that the CDC’s recent “comfortable” guidelines for the vaccinated rely on maintaining appropriate vigilance of the unvaccinated. When an unvaccinated health worker caused an outbreak at a Kentucky nursing facility in March, vaccinated residents were afforded a relatively high level of protection, but 18 of them were nonetheless infected and one died. . Older people seem particularly prone to “rupture infections”, of course. Yet when people choose not to be vaccinated, they have chosen to increase the risk to others.
I should mention that chiropractic has long been associated with anti-vaccination sentiments. Its founder, DD Palmer – who maintained that his theories had been communicated to him by the mind of a long-deceased doctor – rejected the germ theory of the disease, which disposed him to be skeptical of vaccination. Although many contemporary chiropractors believe in vaccines, vaccine skepticism appears to be more common among chiropractors than in the medical world.
Moving on from the ethics of the chiropractor to yours, I would point out that he did not talk to you about his decision in complete confidentiality, which means that you do not have to respect a later request to remain a mother. Why does your chiropractor want you to keep this to yourself? Maybe he thinks clients could take him out of an irrational risk assessment – and some clients might. But it really is a personal decision.
I am planning to have an implantation procedure at my local oral surgeon’s office. I strictly observed all social distancing and masking recommendations during the duration of the pandemic and only made an appointment after I was able to receive a Covid vaccine. At the office for a consultation, I asked the doctor if he was also vaccinated. He told me he was. I then asked one of his assistants, who was about to perform a preliminary intervention on my unmasked mouth, if it was also vaccinated. I did so politely, but she was visibly offended, told me it was none of my business, and left the room.
Is it unethical for me to educate myself on the immunization status of healthcare professionals who perform procedures that require them to be near my unmasked face? Vaccines have been widely available in my state for weeks, and medical staff have been eligible for months. The only reason this person wouldn’t be vaccinated is because they oppose it for spurious ideological reasons. Since the vaccine is not 100% effective, exposure of unvaccinated people still carries some risk. In addition, exerting pressure on the surgeon to force his employees to be vaccinated promotes social good by encouraging herd immunity. I believe that vaccines should be a condition of use in close medical settings. Is this an unreasonable expectation? Name omitted
Your expectation is in fact reasonable (allowing medical and other exemptions). Let’s be clear: Assuming this woman was following the correct protocols, the risks to you were very low, although they would have been even lower had she been vaccinated. Anyway, I don’t think you have any serious reason to worry; I think you had the right to ask. You have the right to assess the risks you are willing to take, and his vaccination status is relevant for this assessment.
Why, then, did she storm off? She may have thought it was your request that reflected “spurious ideology”. Influential voices – a few on television and many online – encourage the belief that the dangers of infection are exaggerated and that there is liberal indoctrination behind the vaccination campaign. One result is to spread the pernicious myth we have discussed: vaccination is simply a “personal decision”. Here we find one of the great lessons of the past year. While a pandemic may require social distancing, an infodemic can be helped by social media distancing.
Kwame Anthony Appiah teaches philosophy at NYU. His books include “Cosmopolitanism”, “The Honor Code” and “The Lies That Bind: Rethinking Identity”. To submit a question: Send an email to [email protected]; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, NY 10018. (Include a daytime phone number.)