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

[SafetyNurse1968]

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.

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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.

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.

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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

[MunoRN, RN]

Nurses can always refuse any actions they want, the question is whether their job or license is protected due to their refusal.

Nurses are not only allowed, but required to refuse to carry out orders that constitute negligence or fail to meet the Standard of Care, or where the patient has not given informed consent, etc. I don't think such an argument can be made for administering a Covid vaccine.  

[CABGpatch_RN, BSN]

Lots of very good points here when it comes to the ethical vs duty of care stuff in nursing.

But....

How many vaccines are actually administered by nurses while a patient is in the hospital or a clinic?  I don't think that these places are where the majority of vaccine is distributed right now, maybe in the relatively far-off future, but not right now.  Where these vaccines are sent to and the types of places people get vaccinated is very controlled and very specific.

The vast majority of vaccine is given by those who specifically want to help stop this monster of a virus.  Most everyone that I know of who vaccinates, signed up for it.  So why is this even a question?

But just to play along, how about if you don't want to give the covid-19 vaccine, you ask a co-worker do it for you?  I would be happy to help get it done.  It takes 30 seconds.

[Guest219794]

On 4/9/2021 at 3:56 PM, Gillyboo said:

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.

Well, 99.3% of people in car accidents survive, but there are other problems caused by car accidents.

 

[CABGpatch_RN, BSN]

On 4/9/2021 at 3:56 PM, Gillyboo said:

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. 

That's not the question that is the topic of this thread is it? ?

[CommunityRNBSN, BSN, RN]

My problem is when people say “We don’t know for 100% certain that it is 100% safe.”  Well, welcome to human life!  There’s a lot we don’t know, and an awful lot that isn’t 100% safe (like riding in a car, taking antibiotics, taking oral contraceptives, camping, letting your child play on a playground) but we do the best we can and move on. 

I work in an outpatient clinic. For the past three months, my job has turned into almost entirely Covid vaccines. I could refuse to give them, but then I’d be out of a job immediately. I suppose it would be my “right” but I can’t imagine why I would refuse to give an ordered medication unless there was a significant reason to believe it would cause harm. And by “significant reason,” I do not mean facebook posts. 
 

We have one nurse who has declined the vaccine for herself, but she vaccinates all day. Because the patients want it, it has been authorized by the FDA, and the doctor has ordered it. I respect that. 

[JKL33]

12 hours ago, MaxAttack said:

"Can nurses refuse to give ordered care?

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

?

Yes. I read that. I voted yes, though I myself have no problems giving it.

When I read your initial response it seemed like you were concerned about all the people who could lose their license for practicing outside their scope of practice. My only point is that the yes responses are not necessarily people who would refuse to give the vaccine, therefore some of them are not subject to your concern/chastisement.

(Although there may also be people who voted no but wouldn't give the vaccine. Possible but seems less likely).

[JKL33]

15 hours ago, macawake said:

I wonder if the 42% who’ve answered that a nurse should be allowed to refuse administering a Covid-19 vaccine also think that I should be allowed to refuse to administer general anesthesia?

Yes, I do think so. Or perhaps what I am arguing is the other side of it--I disagree that in any/every instance someone should be able to tell you what you WILL do with your license, and you must or you will lose your job.

I don't think that, as someone who went through trouble to become educated and to obtain a license that allows you to administer anesthesia, a patient who has not had your education and training and does not stand the risk of losing a license/livelihood, should be allowed to tell you what you WILL do with your license if you do not, in your educated evaluation of the situation, believe it is the best anesthetic approach (or, more specifically, that it carries an unacceptably high level of risk for your patient).

This generally involves the principle of nonmaleficence vs. patient autonomy; one of the real/classic ethical dilemmas. Here in this country refusal to do what a patient requests is sometimes a thing for reasons that could be called far more petty and self-serving than these classic forms of the dilemma--such as a surgeon not wanting to have less-than-stellar surgical outcome statistics on record, or because someone doesn't want to learn a newer (compared to 20 years ago) technique, so they just don't do the newer one and the patient is free to find someone who does.

I understand that I/we have taken this off on a bit of a rabbit trail and if any of my perspective were to be relevant it would need to involve an actual dilemma, not just individual rogue and unscientific "concerns." I also acknowledge that my rebuttals involve sort of a slippery slope argument--which is a concern that may or may not be very likely. However, an RN refusing to give a covid vaccine is not likely to prevent ANY patient anywhere from getting the vaccine, either. It is an extremely unlikely outcome, enough that the umbrage/concern itself is somewhat irrational, since even non-nurses have been administering covid vaccines all across the country. It's a concern that is more a moral and theoretical one for people to become inflamed about.

[FolksBtrippin, BSN, RN]

On 4/9/2021 at 7:18 AM, 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.

I may have missed the point. Where I live, if you are giving covid vaccines, that is all you're doing. So... it's a silly question.

Is it different anywhere else?

[SafetyNurse1968, ADN, BSN, MSN, PhD]

6 minutes ago, FolksBtrippin said:

I may have missed the point. Where I live, if you are giving covid vaccines, that is all you're doing. So... it's a silly question.

Is it different anywhere else?

I don't quite understand what you are saying. "That is all you're doing" What do you mean? Do you mean that there are dedicated vaccination nurses who only give the vaccine? In our state we have many volunteers from multiple backgrounds including, but not limited to: Me - I am a professor of nursing who works full time and also volunteers to give the vaccne; senior level nursing students who are being supervised by faculty; retired RNs in the community, NPs in the community and so on.

If you clarify your question, perhaps I can address it better. I'm also wondering what makes you suggest that my question is "silly"? How does it make you feel when someone tells you a question is "silly"? I feel like it shuts down the conversation - it feels like an attempt to make me feel stupid. Was that your intention? I'm thinking you could word a question differently if you are genuinely interested in conversation. You might consider reading my article about how to argue - it has a lot of helpful tips for how to disagree respectfully. 

 

[Surfin USA]

At times, yes a nurse has a duty to refuse to give the vaccine. For instance, if a person is medically considered "old-old" I.e. over 85, *and* frail, I.e. exceptionally vulnerable to anything, then sometimes any new vaccine, or new drug of any sort, regardless of the overall recommendations, may indeed be dangerous for that person. 

Nurses have at least some responsibility to see to it that the person is a viable candidate for a vaccine. 

 I would think some of these cases would be no brainers here:

The person is currently fighting Covid-19. They wouldnt get a shot. 

The person has a broken bone and has cancer. The vaccine's temporary and generally harmless effects on a typical immune system could indeed kill them. 

The person is underweight due to recently refusing to eat, and has late stage  terminal illness. 

The person is obviously drunk or high, and therefore cannot legally consent. 

The person is unconscious, comatose or in a vegetative state. Clearly they cant consent, but even more importantly,  even if their surrogate (DPOA) wants them vaccinated, the side effects from the vaccine vs. their natural states may be too complicated to differentiate and therefore it would be best to wait or withhold giving them the vaccine. 

The person has or may have a staph infection on their skin, in the area where the injection would take place. Opening the skin around the infected area, could potentially lead to a widespread infection, I would imagine. 

Just some kinda basic reasons (maybe none of these are an exact science LOL, but more an exercise in good judgment of doing NO harm) to refuse to give the vaccine on a case by case basis. 

I also don't know why someone would work for a doctor or hospital that generally employs western medicinal remedies vs holistic ones, if their beliefs contradicted those tenets, but for people who became nurses and also are opposed to certain types of treatments, I think that those nurses should not be forced to have to give someone treatments that go against their beliefs. I just cant imagine these nurses keeping their positions long term, if thats the case. Personally, I don't respect people in health care that refuse to utilize scientifically proven safe methods of improving the quality of a living *and breathing* persons life, but technically they have the right to believe what they want and to practice their beliefs. 

Thank goodness I don't work in HR, I guess. LOL

 

[FolksBtrippin, BSN, RN]

On 4/12/2021 at 8:54 AM, SafetyNurse1968 said:

I don't quite understand what you are saying. "That is all you're doing" What do you mean? Do you mean that there are dedicated vaccination nurses who only give the vaccine? In our state we have many volunteers from multiple backgrounds including, but not limited to: Me - I am a professor of nursing who works full time and also volunteers to give the vaccne; senior level nursing students who are being supervised by faculty; retired RNs in the community, NPs in the community and so on.

If you clarify your question, perhaps I can address it better. I'm also wondering what makes you suggest that my question is "silly"? How does it make you feel when someone tells you a question is "silly"? I feel like it shuts down the conversation - it feels like an attempt to make me feel stupid. Was that your intention? I'm thinking you could word a question differently if you are genuinely interested in conversation. You might consider reading my article about how to argue - it has a lot of helpful tips for how to disagree respectfully. 

 

I sincerely apologize for offending you. 

What I mean is, that in my state (and it sounds like yours also) you're not going to be asked to give a covid vaccine unless you have specifically signed up to do that. If you are opposed to giving the covid vaccine for any reason, you wouldn't sign up to do it. 

Therefore the question of whether or not a nurse should be allowed to refuse to give the vaccine seems to me to be a pointless discussion. 

I feel like we have enough real problems that deserve thought and discussion in nursing. Too many really. So I think that it is a waste of our time and energy to invent problems to discuss. 

[SafetyNurse1968, ADN, BSN, MSN, PhD]

On 4/12/2021 at 9:52 AM, FolksBtrippin said:

I sincerely apologize for offending you. 

What I mean is, that in my state (and it sounds like yours also) you're not going to be asked to give a covid vaccine unless you have specifically signed up to do that. If you are opposed to giving the covid vaccine for any reason, you wouldn't sign up to do it. 

Therefore the question of whether or not a nurse should be allowed to refuse to give the vaccine seems to me to be a pointless discussion. 

I feel like we have enough real problems that deserve thought and discussion in nursing. Too many really. So I think that it is a waste of our time and energy to invent problems to discuss. 

Thanks for the apology - that was very kind. I know only about 10% of communication involves the written word - the rest is lost because so much of how we communicate is nonverbal. 

I proposed the question because I was unsure of whether or not I should give the student an F for refusing to participate in her clinical assignment. It would have been a much better article if I had been more clear about my intention.  What I really wanted to know is "Should I tell my student she has to participate in the assigned clinical experience, which involves giving the COVID vaccine, if she feels philosophically opposed. OR should I spend extra time and energy finding her an alternate assignment?"

Thanks again for commenting - I do appreciate it (This isn't meant to be snarky at all - I am grateful to anyone who comments and participates - I really wish you could hear my voice!)