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Nurses Refusing to Administer COVID-19 Vaccinations!? | Nurses Week Contest

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As a nurse educator, I’ve been discussing the safety and efficacy of COVID-19 vaccines with my students. During my volunteer shifts at local COVID vaccination clinics, I’ve seen plenty of nursing students giving the vaccination. It surprised me when many of my students said they didn’t want the vaccine, but I was even more surprised when one of them said they wouldn’t work at a vaccination clinic because they didn’t believe the vaccine was safe.

Specializes in Oncology, Home Health, Patient Safety. Has 20 years experience.

Can nurses refuse to give ordered care?

  1. 1. Should a nurse be allowed to refuse to give the COVID vaccine?

    • 82
      Yes
    • 114
      No
  2. 2. Are you pro or con regarding vaccines in general?

    • 184
      Pro
    • 12
      Con
  3. 3. Are you pro or con regarding the COVID vaccine?

    • 155
      Pro
    • 41
      Con

196 members have participated

Should nurses be allowed to refuse to administer COVID vaccines?

Nurses Refusing to Administer COVID-19 Vaccinations!? | Nurses Week Contest

Month-Long Nurses Week Celebration Starts Today! Nurses Week Contest #4

Healthcare professionals have expressed vaccine hesitancy due to fear, mistrust, and misinformation. Although nurses are entitled to their opinion, should this influence them when it comes to administering vaccines? Should nurses be allowed to refuse to administer COVID vaccines? What do YOU think? The best Pro or Anti Vaccine read will win $100 Amazon Gift Card courtesy of allnurses Ebooks. Contest rules are found below.

More Nurses Week Contests

Vaccine Controversy

There’s a lot of controversy about the COVID-19 vaccines. I’ve seen articles about how it causes infertility, autoimmunity and even death. Almost 50% of my students have expressed vaccine hesitancy due to fear and misinformation. Some of them have told me they are immunocompromised, and one said that their religion forbids vaccination.  Most of them said, “I just want to wait and see if it’s safe.”

Are vaccinations safe?

There’s been a huge debate for years over whether vaccines cause health problems. When I was about to give birth back in 2009, I did my own research to be absolutely sure that vaccinating my newborn was the way to go. I found no evidence then that vaccination causes autism, and there’s even more evidence now that there is no link between autism and vaccines or any of their ingredients (like thimerosal, which was removed from all vaccines except multi-dose flu vaccines by 2001)1

The flu shot gave me the flu…

You’ve probably heard someone say, “I got the flu vaccine once, and it gave me the flu – I’m never getting it again.” What they don’t realize is that 1) the flu vaccine cannot give you the flu and, 2) in these cases, the person had already been exposed to the flu when they got vaccinated. The development of the flu would have occurred regardless of the vaccination. Modern vaccines are constructed in such a way that they cannot cause the disease for which you are being vaccinated against.

What about the COVID-19 vaccines?

As I stated in the summary, there’s a lot of misinformation about the COVID-19 vaccines including that they cause infertility or autoimmunity.2,3 In addition I have read that they contain a tracking chip and that the RNA from the Moderna and Pfizer vaccines can modify your genes. There is no evidence that any of these assertions are true.4 Though there may be small, isolated cases of side effects occurring with vaccines, they do not outweigh the very real danger of becoming significantly ill from COVID-19. Right now, all the vaccines being used in the US (Moderna, Pfizer and Johnson & Johnson) have 100% efficacy in preventing hospitalization and/or death from COVID-19. Millions of people have been safely vaccinated against COVID-19, and while the evidence is still out as to whether those of us who have been vaccinated can give it to others, we do know that it is working to prevent hospitalization and death from COVID-19.

mRNA technology such as that used in the Moderna and Pfizer vaccines has been around for over a decade. You may recall from A&P or biology that mRNA is made in your body from DNA. The way it works in your body is: Segments of your DNA (called genes) code for mRNA (transcription) and then mRNA codes for proteins (translation). An mRNA vaccine enters your body and is translated into proteins that elicit an immune response. There’s no machinery or ability for your body to incorporate the mRNA into your genetic code. Once it’s translated, the mRNA just gets destroyed by catalytic enzymes.5

It’s also important to note that despite the vaccines being offered under emergency use authorization (EUA), “For this EUA, the FDA required significantly more data on safety and efficacy than usual,” said Janis Orlowski, MD, chief health care officer at the AAMC.5

No serious health problems were reported by the tens of thousands of people who received their vaccines during clinical trials. The most common side effects — fatigue, headaches, chills, and muscle pain — lasted about one day and most often occurred after the second dose. Since the vaccine rollout began in the U.K. and U.S., there have been sporadic reports of severe reactions in people with histories of significant allergic reactions to some foods and drugs.6

Our duty as nurses

The American Nurses Association supports that all nurses get vaccinated for COVID-19.7 The Code of Ethics for Nurses Provision 3 states, “The nurse promotes, advocates for and protects the rights, health and safety of patients.” Not getting a flu vaccine can result in increased risk of contracting flu for patients, co-workers and yourself. Despite this, nurses do refuse to take the flu vaccine – usually due to religious, medical or philosophical objections. Only 21 states have a law that requires healthcare workers to get flu vaccinations and even those laws require exemptions be allowed. Many employers mandate a flu shot, but also allow exemptions. About 1/3 of states require hospitals to offer employees flu shots and track their vaccination status. In many of these states, employees can decline a flu shot without an exemption.8

But what about the COVID-19 vaccines? Can those be required? The federal government says that COVID-19 vaccination can be required, but so far no healthcare organizations have taken this confrontational stance.5,6

I believe we have a duty as nurses to get vaccinated against COVID-19 to protect our patients and coworkers and also to prevent mutations/variations in the vaccine. We all need to work together to eradicate COVID from the planet.

My Question: Can a nurse refuse to GIVE the vaccine?

In nursing school, I recall an ethical debate on whether or not a nurse could refuse to care for a patient having an abortion. We decided that nurses should have the right to refuse to take part in an abortion based on moral objection, though once the pregnancy is terminated, the nurse should no longer be able to refuse to give care. Does that translate to giving vaccinations? If a nurse is morally opposed to vaccinations, can they refuse to give them?

I googled “Can a nurse refuse to administer vaccines” and all I came up with was a list of articles about how many nurses are refusing to get the vaccine. It’s hard to find information on this topic. 

What do you think? Should a nurse be allowed to refuse to give vaccinations? Should the reason for that opposition play a role (religious, ethical, moral, philosophical)?

Contest Rules

  1. Open to registered allnurses.com members only. (Free and quick to Register)
  2. Participate in the Poll.
  3. Answer 'Should a nurse be allowed to refuse to give vaccinations? Why?'
  4. One winner will be announced.

This contest is sponsored by allnurses Ebooks.

download-nursing-specialties-ebook-small.jpg.5b265d60603adce734b7a82d7d729165.jpg Quality Nursing Ebooks. Anytime. Anywhere. Our ebooks are created by nurses, educators, students, and healthcare professionals. We have one goal - To help you succeed in your nursing career.


References

1 Autism and vaccines
2 Why the vaccinations do NOT cause infertility
3 Vaccine myths
4 The vaccine does not cause autoimmune disorders
5 Association of American Medical Colleges: What health care workers need to know
6 COVID-19 vaccine safety
7 ANA position statement on vaccines
8 Becker’s flu shot requirements

Edited by SafetyNurse1968
small grammatical and mechanical errors fixed

Dr. Kristi Miller, aka Safety Nurse is an Assistant Professor of nursing at USC-Upstate and a Certified Professional in Patient Safety. She is also a mother of four who loves to write so much that she would probably starve if her phone didn’t remind her to take a break. Her work experiences as a hospital nurse make it easy to skip using the bathroom to get in just a few more minutes on the computer. She is obsessed with patient safety. Please read her blog, Safety Rules! on allnurses.com. You can also get free Continuing Education at www.safetyfirstnursing.com. In the guise of Safety Nurse, she is sending a young Haitian woman to nursing school and you can learn more about that adventure: gf.me/u/xzs5sa

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83 Comment(s)

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

If there is no proven immediate safety concern then I think they need to give it. 

FolksBtrippin, BSN, RN

Specializes in Psychiatry, Pediatrics, Public Health.

These questions are silly. Of course you can refuse an assignment. We're nurses not slaves. 

SafetyNurse1968, ADN, BSN, MSN, PhD

Specializes in Oncology, Home Health, Patient Safety. Has 20 years experience.

8 hours ago, FolksBtrippin said:

These questions are silly. Of course you can refuse an assignment. We're nurses not slaves. 

I was taught in nursing school that you had to have a compelling reason to refuse in assignment. I remember this being especially important when considering race, it’s been a while but don’t you remember discussing whether or not you could refuse an assignment because the patient was someone you just didn’t want to take care of? I recall as a new nurse I had a patient who was a child abuser, and I was pretty disturbed by that and I talked to my charge nurse about how I really didn’t want to care for the patient. I remember seeing in her eyes how disappointed she was in me that I wasn’t able to compartmentalize.

speedynurse, ADN, RN, EMT-P

Specializes in ER, Pre-Op, PACU.

2 hours ago, SafetyNurse1968 said:

I was taught in nursing school that you had to have a compelling reason to refuse in assignment. I remember this being especially important when considering race, it’s been a while but don’t you remember discussing whether or not you could refuse an assignment because the patient was someone you just didn’t want to take care of? I recall as a new nurse I had a patient who was a child abuser, and I was pretty disturbed by that and I talked to my charge nurse about how I really didn’t want to care for the patient. I remember seeing in her eyes how disappointed she was in me that I wasn’t able to compartmentalize.

This nursing student may very well have a compelling reason - and she is simply not comfortable with telling you if she doesn’t perceive you as being willing to understand her viewpoint. I am one that I feel like education should be provided and then everyone should be allowed to make an educated decision - this applies to anything in the healthcare field. I have seen many receive the vaccine and do great - I have also seen others struggle with high fevers for days and complications of underlying health issues. There is an article out now that a vaccine site is being shut down in NC for investigation of adverse effects. I do think there needs to be a level of understanding with concerns whether pro or wariness of the vaccine because it WAS approved for emergency use. There are many meds out there with full FDA approval that were recalled years later because of MI tendencies, higher risk of cancer development, etc. I think this is an area where everyone has to use their own judgment- be kind and try to understand everyone’s viewpoints. I am one that I am ready for covid to be OVER! However, I think for that to be over, it will be multifaceted- because of mutations, vaccines, masks, etc. Regardless, I think this is a time that requires a little extra effort to understand each other. 

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

Many medications have potentially serious side effect profiles- can we start refusing to give those as well?

SafetyNurse1968, ADN, BSN, MSN, PhD

Specializes in Oncology, Home Health, Patient Safety. Has 20 years experience.

40 minutes ago, Jedrnurse said:

Many medications have potentially serious side effect profiles- can we start refusing to give those as well?

Good point! I look forward to seeing what others think of this question. There are gray areas everywhere. I love a good ethical debate.  Thanks to everyone who has contributed so far.

52 minutes ago, speedynurse said:

This nursing student may very well have a compelling reason - and she is simply not comfortable with telling you if she doesn’t perceive you as being willing to understand her viewpoint. I am one that I feel like education should be provided and then everyone should be allowed to make an educated decision - this applies to anything in the healthcare field. I have seen many receive the vaccine and do great - I have also seen others struggle with high fevers for days and complications of underlying health issues. There is an article out now that a vaccine site is being shut down in NC for investigation of adverse effects. I do think there needs to be a level of understanding with concerns whether pro or wariness of the vaccine because it WAS approved for emergency use. There are many meds out there with full FDA approval that were recalled years later because of MI tendencies, higher risk of cancer development, etc. I think this is an area where everyone has to use their own judgment- be kind and try to understand everyone’s viewpoints. I am one that I am ready for covid to be OVER! However, I think for that to be over, it will be multifaceted- because of mutations, vaccines, masks, etc. Regardless, I think this is a time that requires a little extra effort to understand each other. 

Speedynurse, thank you for reminding us all to be kind and open minded. I so appreciate that advice.

1 hour ago, speedynurse said:

There is an article out now that a vaccine site is being shut down in NC for investigation of adverse effects.

Yes, fainting...fainting. How on earth is that an adverse affect of a drug? 🤔

SafetyNurse1968, ADN, BSN, MSN, PhD

Specializes in Oncology, Home Health, Patient Safety. Has 20 years experience.

1 hour ago, speedynurse said:

This nursing student may very well have a compelling reason - and she is simply not comfortable with telling you if she doesn’t perceive you as being willing to understand her viewpoint. I am one that I feel like education should be provided and then everyone should be allowed to make an educated decision - this applies to anything in the healthcare field. I have seen many receive the vaccine and do great - I have also seen others struggle with high fevers for days and complications of underlying health issues. There is an article out now that a vaccine site is being shut down in NC for investigation of adverse effects. I do think there needs to be a level of understanding with concerns whether pro or wariness of the vaccine because it WAS approved for emergency use. There are many meds out there with full FDA approval that were recalled years later because of MI tendencies, higher risk of cancer development, etc. I think this is an area where everyone has to use their own judgment- be kind and try to understand everyone’s viewpoints. I am one that I am ready for covid to be OVER! However, I think for that to be over, it will be multifaceted- because of mutations, vaccines, masks, etc. Regardless, I think this is a time that requires a little extra effort to understand each other. 

I live in NC and found an article about the recent shut down: “All those taken to hospitals are expected to recover, local health officials said.” https://www.nydailynews.com/news/national/ny-raleigh-covid-vaccine-site-shutdown-20210408-26bgpjshpjbitg2qlyqm54rxie-story.html?outputType=amp

spotangel, DNP, RN, NP

Specializes in ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds. Has 32 years experience.

Whatever happened to patient care? If you are totally opposed to say, abortions, don't work there. I am pro life and in my clinic we do both prenatal care, contraception and abortions. My partner or the provider counsels patients that are interested in abortion as an option. I am not part of it but the patient gets the help they need. They come for help and get the help. Trust me, I find it hard and uncomfortable but make sure they get the help they need.

   On the same token, I had an anaphylactic reaction to the Moderna vaccine first dose and cannot take the second dose. I just signed up for next weekend vaccination clinic to give 600 doses. At the end of the day, I am a professional and help my patient regardless of my beliefs. I am a resource if they have questions both pro and cons. Our patients trust what we say as we ARE the number #1 trusted profession in the world!

Actually, federal law prohibits employers mandating any emergency use vaccine, prior to FDA approval. The reasoning is mostly because efficacy is not especially clear yet, and neither are side effects. Additionally, the drug maker is immune from liability, during the time that EUA vaccines are administered. 

https://www.statnews.com/2021/02/23/federal-law-prohibits-employers-and-others-from-requiring-vaccination-with-a-covid-19-vaccine-distributed-under-an-eua/

That said, it is not unprecedented to mandate what we would now call EUA vaccines. In 1905, smallpox was killing a lot of people, a was mandated even for employees. The benefits simply outweighed the risks to take a cowpox vaccine back then. Smallpox wasnt eradicated until more than half a century later. It's the only disease that has been totally vanquished. Smallpox in the Variola Major variety (the kind that left pockmarks) averaged only a 70% survival rate. So, at the time, cowpox were truly a Godsend. 

With Covid-19, there is generally a 96% survival rate for adults and a 99% survival rate in children. Not a super small number, but clearly small enough to make some people feel they are better taking their chances and not getting vaccinated. 

We could easily wait to get the shots. 

I am fully vaccinated, myself, but I do like to argue the less popular opinion, just for a bit of a challenge, if nothing else. Ha 🙂

 

SafetyNurse1968, ADN, BSN, MSN, PhD

Specializes in Oncology, Home Health, Patient Safety. Has 20 years experience.

Just now, Gillyboo said:

Actually, federal law prohibits employers mandating any emergency use vaccine, prior to FDA approval. The reasoning is mostly because efficacy is not especially clear yet, and neither are side effects. Additionally, the drug maker is immune from liability, during the time that EUA vaccines are administered. 

https://www.statnews.com/2021/02/23/federal-law-prohibits-employers-and-others-from-requiring-vaccination-with-a-covid-19-vaccine-distributed-under-an-eua/

That said, it is not unprecedented to mandate what we would now call EUA vaccines. In 1905, smallpox was killing a lot of people, a was mandated even for employees. The benefits simply outweighed the risks to take a cowpox vaccine back then. Smallpox wasnt eradicated until more than half a century later. It's the only disease that has been totally vanquished. Smallpox in the Variola Major variety (the kind that left pockmarks) averaged only a 70% survival rate. So, at the time, cowpox were truly a Godsend. 

With Covid-19, there is generally a 96% survival rate for adults and a 99% survival rate in children. Not a super small number, but clearly small enough to make some people feel they are better taking their chances and not getting vaccinated. 

We could easily wait to get the shots. 

I am fully vaccinated, myself, but I do like to argue the less popular opinion, just for a bit of a challenge, if nothing else. Ha 🙂

 

How interesting! The article I cited said that hospitals could legally require the COVID vaccine because it has an EAU. As usual, there’s a lot of conflicting information out there. I love productive discourse. Thanks for weighing in with supported info.

macawake, MSN

Has 13 years experience.

6 hours ago, speedynurse said:

I am one that I feel like education should be provided and then everyone should be allowed to make an educated decision - this applies to anything in the healthcare field.

6 hours ago, speedynurse said:

I do think there needs to be a level of understanding with concerns whether pro or wariness of the vaccine because it WAS approved for emergency use. There are many meds out there with full FDA approval that were recalled years later because of MI tendencies, higher risk of cancer development, etc. I think this is an area where everyone has to use their own judgment- be kind and try to understand everyone’s viewpoints.

I have to admit I don’t understand this line of thinking. First of all, is it an educated decision to be more fearful of the vaccine than a Covid infection? 

I dislike paternalistic medicine. If a patient wants a vaccine that is legal to give and understands the risks and that there might be unknowns, how is it ethical to deny them a vaccine? I’m not trying to be mean here, I genuinely don’t understand why a nurse would think that their personal fears or needs trumps the needs and wishes of the patient. 

I noticed that you specialize in pre-Op and PACU. I work the in-between. What if I would tell my patients that I’m sorry, but I really can’t administer anesthesia. While anesthesia-related mortality is very low, it’s not zero.
So should I tell my patient that I’m not comfortable with the risk involved? Sure I realize that from the patient’s perspective there is a lot of benefit from the various drugs used and that the patient would really, really like to have them before and during their surgery, but I can’t live with the risk. I guess I could offer them a couple of aspirin instead? No wait.. Can’t do that either because aspirin could cause severe side effects. Don’t even get me started on oncology nurses who administer chemotherapy. 

If every nurse starts to unilaterally decide which legally prescribed medication or treatment he or she is comfortable administering, where does that leave the patient?

I think that if an informed and consenting patient wants to accept a legal treatment/med that a provider has prescribed, we have to give it if it’s within our scope to do so. Or seek employment somewhere you don’t ever have to give medication x or treatment y. 

I absolutely think the student has the right to choose not to apply for a job in a vaccination clinic, but doesn’t have a right to veto a patient’s autonomy. 
 

I do agree with you on two things. I too can’t wait for Covid to be over and I think you’re right that kindness is important, especially in trying times like the one we’re living right now. 
 

Take care 🙂

 

Tenebrae, BSN, RN

Specializes in Mental Health, Gerontology, Palliative. Has 9 years experience.

Its sort of like abortion in that if you don't want to give a vaccine, don't work in an area that requires you to give vaccines. don't sign up to work in that area and then state you won't give vaccines. 

Personally I could never work in an area that provides abortions based on my own personal feelings, doesn't mean I'd stand between a woman obtaining an abortion or not refer them onto a service that could help

Provaccines, and when the covid vaccine is avaliable at work I'll be signing up to get it. 

Many times I had to administer IM Rocephin when I didn't think it was necessary. One provider may deem the antibiotic beneficial and order it. A second provider may choose to order oral antibiotics. A third provider may choose to let an illness run its course without ordering any medication. How is refusing to administer the Covid vaccine any different than refusing to administer any other medication?

3 hours ago, macawake said:

If a patient wants a vaccine that is legal to give and understands the risks and that there might be unknowns, how is it ethical to deny them a vaccine? I’m not trying to be mean here, I genuinely don’t understand why a nurse would think that their personal fears or needs trumps the needs and wishes of the patient. 

I would agree with this if a random nurse refusal meant that someone would be denied the recommended care. I am not sure how often that has ever been the reality, though I admit it could theoretically result in that.

***

Re: the OP question at hand. I voted no, sort of for devil's advocate reasons but also a bit of a very broad application of the question. I have indeed refused to give an ordered medication before, but not for moral, political or philosophical reasons; it was that I had very good reason to believe that the med/plan of care was both unnecessary and dangerous as well as somewhat off the beaten path. So, as a last resort I decline and invited the physician to administer it  if they really thought it was a reasonable plan (they decided to change their mind instead). And I would like to retain my "right" to exercise my nursing judgment to do that same thing again, which is what I would do.

With the covid vaccine specifically, I do think that the few people whom I've heard say they wouldn't administer it, they seem to be exercising a...sudden intensity of concern and nursing judgment...that is...uncharacteristic.

****

9 hours ago, speedynurse said:

There is an article out now that a vaccine site is being shut down in NC for investigation of adverse effects.

Sounds like they're going to be back up and running since the CDC investigated the batch/lot and found no cause for concern.

https://abc7chicago.com/adverse-reaction-to-johnson-and-shot-jj-covid-vaccine-side-effects-north-carolina-pnc-arena/10501577/

 

RN-to- BSN, ADN, RN

Specializes in SCRN. Has 7 years experience.

On 4/8/2021 at 7:44 PM, SafetyNurse1968 said:

I believe we have a duty as nurses to get vaccinated against COVID-19 to protect our patients and coworkers and also to prevent mutations/variations in the vaccine. 

No, nurses are also people with opinions, and getting a COVID vaccine is a choice, not a duty.

16 hours ago, Tenebrae said:

don't work in an area that requires you to give vaccines.

agree

MaxAttack

Specializes in Trauma/Surgical & Neuro Critical Care. Has 6 years experience.

How have so many people voted yes on this??

Would you refuse to administer an antibiotic? Tylenol because you don't like Johnson & Johnson? Taking a job that includes administration of vaccines and then refusing to administer them cannot be twisted into some noble deed any more than the pharmacist that purposefully destroyed over 500 doses of the covid vaccine.

We have an obligation to critically think and and use our judgement to a point. For those of you that think you can unilaterally determine the risks vs benefits and essentially write or d/c your own orders need to seriously review nursing laws and scope of practice because you won't be the first to lose your license thinking you ultimately decide what a patient should and should not receive.