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.

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.

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

[FolksBtrippin, BSN, RN]

20 minutes ago, SafetyNurse1968 said:

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!)

Ahh... I missed the whole part about you having a student who refused to give a covid vaccine.

So it is an important discussion indeed. I thought I might be missing something and I was!

I think that I would not fail the student. It's a teachable moment isn't it? Maybe I would ask her to write an essay backed up with empirical evidence that explains why she refuses to give the vaccine. Maybe she believes it is harmful. This should be explored.

A student that won't do something against her values should be encouraged to explore the beliefs that set up the values, but I think, should not be forced to go against those values. We need nurses who will have the guts to stand up for what is correct (and we also need them to know what is correct).

 

[MaxAttack, BSN, RN]

2 hours ago, JKL33 said:

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).

I'm not sure why you're splitting hairs here. My reply is for anyone who feels, whether for themselves or others, that they have the legal standing to refuse to administer a medication based on misinformation and facebook posts. If you voted yes then my response is as much for you as anyone else.

[MaxAttack, BSN, RN]

1 hour ago, Gillyboo said:

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. 

These are good examples. Someone at the age of 85 has a greater risk of drying from covid than someone at the age of 25. If an 85 year old, after discussing the risks and benefits with their provider, wishes to receive the vaccine, what legal standing would a nurse have to override both the patient and provider and refuse?

[Hannahbanana, BSN, MSN]

It's established that if you have a religious/moral exception to abortion or blood transfusions that you don't have to participate in performing them. The PATIENTS have a right to decline care that is not in concert c their religious or cultural values, such as being cared for by a member of the opposite sex or eating food from the kitchen that doesn't meet their religious prohibitions.

However, that doesn't allow that "I don't like it" attitude to spread to anything else you don't agree with. If you're an Adventist, do you have the right to decline care to somebody who isn't vegetarian? If you're a Jehovah's Witness, can you be excused for caring for somebody who got a blood transfusion yesterday? If you are Sikh, can you refuse to care for a man with a crew cut? Likewise, if you are working in a science-based profession, can you refuse to administer any treatment about which you demonstrate that you don't understand the science?

When a student has an objection to a vaccine based on a false set of disinformation ("It's untested/it's unsafe/I might be pregnant and it will hurt my baby/I want to get pregnant and it will make me sterile/it has particles in it that will let Billy Gates track me on 5G/it has fetal cells in it......") not only do they need to know that these are not moral/religious objections covered by the law, but they are not fact-based, and that therefore they are obligated to care for the patient in front of them who needs and requests this care. It's a great topic for postconference, preferably guided by a nurse ethicist.

[JKL33]

On 4/12/2021 at 10:46 AM, MaxAttack said:

I'm not sure why you're splitting hairs here.

That was not my intent. I thought it was more an interesting point about what a 'yes' vote might represent. In your first post you launched quite a mini-diatribe about people losing their licenses that appeared to me to assume that everyone who voted yes would refuse to give the vaccine. Except that was an incorrect assumption because that is not what the poll question asked. That is all I meant to point out and I did so because I think it is relevant: I think the number of people who voted yes, for various reasons, is quite possibly higher than the number of people who have any intention of ever refusing to administer the covid vaccine.

On 4/12/2021 at 10:46 AM, MaxAttack said:

My reply is for anyone who feels, whether for themselves or others, that they have the legal standing to refuse to administer a medication based on misinformation and facebook posts. If you voted yes then my response is as much for you as anyone else.

I couldn't possibly care less if you wish to include the likes of me in your feelings of disapproval. But your doomsday license-losing scenario that you initially posted still actually does not apply to me with respect to administering the covid vaccine.

[macawake, MSN]

4 hours ago, SafetyNurse1968 said:

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?"

I can’t think of a valid reason to be ”philosophically” opposed to saving lives. That’s what Covid-19 vaccines do. If I understand you correctly, your student’s refusal is a blanket one. It’s not about taking circumstances of a specific patient or particular situation into consideration. S/he just doesn’t want to administer any Covid vaccines to any person. Unless the student is in possession of factual evidence that the risks outweigh the benefit, I think her/his stance is ethically problematic. It’s an F in my book. 

[macawake, MSN]

7 hours ago, JKL33 said:

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).

I don’t think I managed to make my point very clearly. I wasn’t asking if I should be allowed to use my professional judgment. Of course I, and all other nurses, should be allowed that. But the key word is professional. My decisions would actually be based on facts or evidence.

In my example above I was asking if I should be able to just refuse to provide anesthesia to any patient for no rational reason at all. Just my own discomfort or fear about the unknown. I don’t think that would be compatible with remaining employed in my current position and I don’t think it would be the ethically correct choice. 
 

7 hours ago, JKL33 said:

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.

I agree. It can easily become a slippery slope argument. If the standard is that every refusal to carry out lawful and beneficial orders that the patient also wants, is acceptable as long as there is someone else who can administer the medication or intervention...  What would the consequences be for the patient?

Let’s say I’m philosophically opposed to urine and feces (I actually am). Is it okay that I let my patient sit their soaked in their waste products? Is it okay if the patient has to wait an extra ten minutes until someone who is less squeamish is available to help them? What if the only nurse or CNA who doesn’t object to the task is on night shift and it’s only 11 am... How much extra wait time for the patient is acceptable before my refusal become unethical?
 

[JKL33]

On 4/12/2021 at 3:34 PM, macawake said:

I don’t think I managed to make my point very clearly. I wasn’t asking if I should be allowed to use my professional judgment.

I did at first think you were commenting as if you felt that you should be told that you WILL administer general anesthesia as long as the patient was willing to accept the risks of it, because that is kind of how the discussion was going immediately prior to your comment (if I'm remembering correctly; didn't go back to check). It was along the lines that a nurse should not be able to decline to participate in something if it's what the patient has already made (their version of) an informed decision about. Then it did come to mind that you might be talking about what would happen if you wanted to work in a full-service CRNA role but be excused from ever providing general anesthesia. Which is obviously dicier and is more along the lines of what this discussion is about.  ?

On 4/12/2021 at 3:34 PM, macawake said:

In my example above I was asking if I should be able to just refuse to provide anesthesia to any patient for no rational reason at all. Just my own discomfort or fear about the unknown. I don’t think that would be compatible with remaining employed in my current position and I don’t think it would be the ethically correct choice. 

A good point. Hm.  Well I suspect part of the problem is that for a lot of people (?most people), if they feel a significant discomfort or concern they aren't going to tend to think of that concern as being borne out of "no rational reason at all."  I don't mean that to be a defense or a supporting argument, but it is indeed a real problem. Don't you think? Don't most people run some risk of being unable to fully see their own blind spots?

In other words, if the RN believed and understood that they had "no rational reason at all" to refuse to administer covid vaccines, then....they'd probably be willing to administer the vaccine.

On 4/12/2021 at 3:34 PM, macawake said:

I agree. It can easily become a slippery slope argument. If the standard is that every refusal to carry out lawful and beneficial orders that the patient also wants, is acceptable as long as there is someone else who can administer the medication or intervention...  What would the consequences be for the patient?

Having a hard time reading the tone ^ here. I hope you know I wasn't calling your argument a slippery slope (?) - I was acknowledging that my own argument (which was along the lines of 'but what if you really had a legitimate concern about something') was itself a bit of an awkward argument because the concern we are talking about in this specific case is not a well-defined legitimate concern. But I will try to comment on your next part anyway:

On 4/12/2021 at 3:34 PM, macawake said:

Let’s say I’m philosophically opposed to urine and feces (I actually am). Is it okay that I let my patient sit their soaked in their waste products? Is it okay if the patient has to wait an extra ten minutes until someone who is less squeamish is available to help them? What if the only nurse or CNA who doesn’t object to the task is on night shift and it’s only 11 am... How much extra wait time for the patient is acceptable before my refusal become unethical?

I don't know! Maybe we should use "lengths of time patients wait when the waits are caused by purposeful short-staffing" as a benchmark.(Kidding...sort of). But...honestly...plenty of people have been waiting significant lengths of time for their covid vaccines, and it's unlikely that a single one of them had anything to do with an RN refusing to administer it. That's why I get testy: There IS some portion of discussions like this (in general, not directed toward you personally) that end up being about the sport of making moral judgments against peers.

I can't answer your question. All I can say is that I prefer not to consider something much of a problem if it isn't a realistic/practical problem. The RNs who don't want to administer covid vaccines 1) are likely fewer than this poll might seem to indicate, as I have already pointed out and 2) may or may not ever even find themselves in a position to have to worry about it to begin with. Once those factors are accounted for then we finally get to the part about how there are plenty of people who WILL happily administer as many covid vaccines as they possibly can. Therefore I believe that alleged concerns about patients being "denied care" in this particular situation are barely more rational than the concerns about administering the vaccine.

[MaxAttack, BSN, RN]

On 4/12/2021 at 2:28 PM, JKL33 said:

That was not my intent. I thought it was more an interesting point about what a 'yes' vote might represent. In your first post you launched quite a mini-diatribe about people losing their licenses ...

LOL "chastisement," "diatribe," "doomsday." I'm not sure why the hate but I love your flair for the dramatic. An actually interesting point could have been why one would not put themselves into legally questionable territory but would support others doing so. You know, constructive contributions ?

Not looking for an answer but just food for thought.

[Smepps]

To answer the question "Can a Nurse Refuse to Give the Vaccine". At first my response was YES because the vaccine may not be appropriate at the time, such as the patient may have received another vaccine to close to administration (14 day before or after 2nd) or the patient may be allergic to a component. However, regarding ethical or moral issues, the nurse may not believe in vaccines and that is a personal preference, but should still provide the preventive care needed as a nurse for a patient. If there a certain aspects of providing care as a nurse is not ideal for some then maybe they should find another profession or specialty. Our goal as nurses should be to provided care for those who may be unable to care for themselves, to nourish, encourage, and protect.

 

[Surfin USA]

On 4/11/2021 at 8:54 PM, hherrn said:

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

My point exactly. 

The issue here I think is that so many people really only see these survivorship numbers and fail to recognize that there have been 2 million people killed by this virus worldwide. 

When the pandemic started, and started affecting us, I had a client whose family members were also nurses and, uhh trying to not risk making any potentially identifying information public, but, yeah, they had a family full of health care workers anyways, and those people were purposely having large family gatherings of 25+ people every week. 

It was a brand new tradition they had started last March. 

I asked my employer for help, and was told to write an email stating the (high risk) client was non compliant with their care plan. The case manager even got involved and the client suspended care for a couple of weeks and then eventually chose to stop their home care altogether. What??? And that makes no sense because we were like Forrest and Jenny.. we were peas and carrots LOL. 

But I think the client was on the more passive side and lacked the ability to assert their position in the matter so IDK. Anyways I didn't feel comfortable with that level of possible exposure, so it worked out pretty well, in the long run. 

It is so completely mind boggling how people can be so ignorant about the extensive reach of this virus. 

And  I am very disappointed in how much misinformation and rhetoric has been spread even since then. It's really a big issue and is not limited to refusing to give a shot. 

Its been systemic, from jump. 

[MaxAttack, BSN, RN]

8 hours ago, Smepps said:

To answer the question "Can a Nurse Refuse to Give the Vaccine". At first my response was YES because the vaccine may not be appropriate at the time, such as the patient may have received another vaccine to close to administration (14 day before or after 2nd) or the patient may be allergic to a component. However, regarding ethical or moral issues, ... 

It could have been worded better. I'm not the OP but I imagine they meant ethically/morally and that's what lead to some of the confusion and debate. Asking if someone could refuse to administer an inappropriate dose due to timing/contraindications/etc is like asking if a surgeon could refuse to operate on the wrong limb ?