What If a Colleague Refuses the COVID Vaccine?

Alok S. Patel, MD


January 26, 2021

This transcript has been edited for clarity.

All over social media, people are sharing photos and selfies of themselves getting the COVID-19 vaccine. They are really excited about the light at the end of the tunnel, and that light is a vaccine that is going to get us to herd immunity.

At the time of this recording, I haven't seen any hospitals making the shot mandatory for healthcare professionals. Enthusiasm and compliance have been high, as they should be. With everything that is at stake, I want to ask you: Do you think getting the COVID-19 shot should be a requirement for healthcare professionals?

My next question is, does it even need to be required? Susan Bailey, the president of the American Medical Association, said she was confident that once physicians saw the evidence behind the vaccine, they would go out and get the shot. Well, they have and they are. I think this is true with all healthcare professionals.

Case in point: Many of you saw the video of one of the first people to get the shot, a critical care nurse in New York City. I love what she said: "I trust the science and I guide my practice by it." Since then, thousands of healthcare workers have followed suit, have shared photos and facts about the vaccine, and have debunked misinformation.

Unfortunately, there is still some reluctance within the medical community about the vaccine. That's why we're talking about this. According to an October survey, only one third of US nurses said they're willing to go and get the shot. Now, granted, that was a little while ago. More recently, per the executive director of the Association for Immunization Managers, state and local health departments are reporting that only about 50%-70% of healthcare workers said they were going to go and get the vaccine.

In early December, I read a Medscape article about vaccine side effects. I noticed the comment section was littered with rants from healthcare workers talking about why they were not going to go and get the shot. Hopefully, all the recent data have swayed some of them, but who really knows.

Plenty, if not all, major healthcare organizations stand by the science of the vaccine and trust it — the FDA, CDC, ACIP, American Hospital Association, AMA, ANA, AAP, and the list goes on.

Many hospitals are just waiting for full FDA approval rather than emergency use authorization to mandate the shot. Maybe healthcare systems just need more time and more data.

Can you imagine working in a COVID unit and one of your colleagues refuses the vaccine? Maybe a mandate would remove the personal politics from all of this by sending a clear signal, saying, "We want our workers to get the shot," like they do with the flu shot. But maybe a mandate that is rushed would cause more mistrust and division.

The legality of all this is yet another topic. A recent article by healthcare attorney Carolyn Buppert made me think and raised some questions. What happens with worker's compensation if a hospital employee refuses the COVID-19 vaccine and then gets sick with it? I know we are still waiting to see what happens with transmission after getting vaccinated. In theory, would a hospital be liable if an employee refuses the vaccine and then goes and causes an outbreak? It's a lot to think about.

We play a crucial role in building public trust, not only with the vaccine itself but also with the entire process that got us to approval, from research to review. Maybe this entire discussion will fade in time and healthcare workers will unanimously march out and get their shots. Maybe it will evolve into a more complicated topic that will push national organizations to support a mandate.

Hopefully, in the meantime, we won't have to have difficult conversations with vaccine-hesitant peers. But time will tell.

For now, what I want to know from all of you is whether you think the COVID-19 vaccine should be mandatory for frontline healthcare workers. Please comment below. And don't forget to share your vaccination pics with #MyCOVIDVax.

Alok S. Patel, MD, is a pediatric hospitalist, television producer, media contributor, and digital health enthusiast. He splits his time between New York City and San Francisco, as he is on faculty at Columbia University/Morgan Stanley Children's Hospital and UCSF Benioff Children's Hospital. He hosts The Hospitalist Retort video blog on Medscape.

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