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.

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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

[Kooky Korky, BSN, RN]

On 4/8/2021 at 10:07 PM, FolksBtrippin said:

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

Not silly at all.

While a nurse might have the right to refuse an assignment, there are often dire consequences to refusing.  Like getting fired, blacklisted.

Often the nurse must do the assignment, even if under protest.  And the discussion, if any, about why the nurse wanted to refuse, comes after the fact.  Just another ploy by employers to staff inadequately.

We all need to find work that is compatible with our innards, if at all possible.

 

[JKL33]

On 4/14/2021 at 9:08 AM, MaxAttack said:

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.

I have no hate for you, whoever you are, speaking of a flair for the dramatic.

I just think you misjudged what a yes vote might mean and are having a hard time admitting it.

Other than that you're good with me (if that matters). ???

[JKL33]

On 4/14/2021 at 6:42 PM, MaxAttack said:

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 ?

Well, I originally made the vote I did because this profession is not fond of sorting out nuance when it comes to employee actions. For example, I have worked with coworkers (including management) who really do think that the hospital is de facto guilty of an EMTALA violation if a patient decides not to be seen after they have checked in to the ED. I have worked with many who don't understand what HIPAA is and isn't - including plenty in management. So my preference would not be that we declare an action itself something that one should or should not be "allowed" to do. It isn't completely beyond reason that, when the question is asked whether nurses should be allowed to refuse X, it should bear some pondering before everybody votes a certain way due to the opportunity to decry this situation.

I also don't like the aspect where once again there is focus on the individual and their immoral actions. Trust me, if there were no significant FINANCIAL interest in getting people vaccinated, health systems WOULDN'T involve themselves in it, just like they are completely loathe to involve themselves in psychiatric care and anything else that isn't profitable. 

I get holding ourselves to high standards, but we are currently dissing people who, for whatever reason (some of which are poor) don't want to be involved in administering covid vaccines. Meanwhile, we've been limping for over a year through a situation where this entire profession suffered greatly and more than necessary, due directly to betrayal by big businesses that CHOSE....FREELY CHOSE to specifically NOT be prepared for something like this, even remotely. Where they were making you give your name and put your first-born up for collateral* in order to get a damn N95 mask to use for the next 6 weeks. Now we're gonna talk about whether there are some people scattered here and there who might not want to administer the covid vaccine???? Come on.

I will admit, @MaxAttack that I argue a little more bluntly sometimes (or am more argumentative) because frankly I get freaking sick of the "should a nurse..." [do/not do X thing someone considers moral/immoral]. I have no clue why the morality-related questions and arguments are so frequently about what nurses do. Meanwhile they're working in a system that is significantly corrupt and about that, people just...??‍♀️ and make excuses for it. But love to point out when their entry-level peer isn't acting they way they think the peer should act.

So...I will humble myself and apologize that, yes, these ^ thoughts added some additional vigor to some of my replies.

*Yes, hyperbole/exaggeration. Only slight, though.

[vmbennett, BSN]

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

Should a nurse be allowed to refuse to give vaccinations? Why?'

My answer needs to be based, in part, on the law related to previous vaccines, influenza. There are no state or federal laws that either require an employee to be vaccinated against COVID-19 or that protect an employee who refuses vaccination against COVID-19 or refuses administering the vaccine. It will take a while after the vaccine is approved and distributed before reactions, policies, cases, and laws begin to emerge.

Some healthcare professionals strongly feel that if people want this vaccine, they should receive it. But just like it’s their choice to receive it or not, the healthcare professionals feel like it should also be their choice to give it or not. So, yes, until the laws change, a nurse should be allowed to refuse to give the vaccine. Studies involving tens of thousands of people found that the two vaccines approved for emergency use in the U.S. are nearly 95% effective at preventing COVID-19 illness. The studies discovered no major safety problems, although the vaccines do come with a caution about rare, serious allergic reactions. That’s why people are supposed to be observed for 15 minutes after the injection, so any adverse reactions can be treated promptly. But because very rare side effects sometimes can’t be detected until vaccines are given to millions of people, multiple systems now are tracking recipients’ health so authorities can rapidly investigate any reported problems and determine if they’re related to the shots.

If we look at the law related to healthcare workers refusing to be vaccinated against the closest relative to COVID-19 — influenza — then the answer would be yes, employers can require employees to be vaccinated. An employer can fire an employee who refuses influenza vaccination. If an employee who refused and was fired sues the employer for wrongful termination, the employee has less chance of success depending on the reason for refusal. Some courts and the US Equal Employment Opportunity Commission (EEOC) have held that a refusal on religious grounds is protected by the US Constitution. A refusal on medical grounds has been successful if the medical grounds fall under the protections of the Americans with Disabilities Act (ADA) but may fail when the medical grounds for the claim are not covered by the ADA. The situation with the COVID-19 vaccine is different from the situation surrounding influenza vaccines. There are plenty of data on effectiveness and side effects of influenza vaccines, but there is very little evidence of short- or long-term effects of the COVID-19 vaccines currently being tested and/or considered for approval. One could argue that the process of vaccine development is the same for all virus vaccines. However, public confidence in the vaccine vetting process is not what it once was. It has been widely publicized that the COVID-19 vaccine trials have been rushed. Human beings respond better to empathy and patience than to pressure.

[MaxAttack, BSN, RN]

On 4/24/2021 at 4:45 PM, vmbennett said:

professionals strongly feel that if people want this vaccine, they should receive it. But just like it’s their choice to receive it or not, the healthcare professionals feel like it should also be their choice to give it or not. So, yes, until the laws change, a nurse should be allowed to refuse to give the vaccine. Studies involving tens of thousands of people found that the two vaccines approved for emergency use in the U.S. are nearly 95% effective at preventing COVID-19 illness. The studies discovered no major safety problems, although the vaccines do come with a caution ...

The argument here is that a nurse should be able to withhold a potentially life-saving option because there are theoretical risks associated with it. But aren't there risks associated with *any* new medication, or really any medication period? I know the vaccine is new and there are risks and I still got it. I also know we don't know the long-term effects of COVID. So the same question remains: under what legal standing does a nurse have the authority to refuse to administer a vaccine after a provider and patient have already evaluated and discussed the risks vs benefits for that individual patient?

For me an easy way to evaluate this is to use the same logic in another setting - can I refuse to bring a patient to the OR because I believe the risk of surgery outweighs the benefits of extending an already diminished quality of life for my critically ill patient in his 80's?

[Surfin USA]

36 minutes ago, MaxAttack said:

The argument here is that a nurse should be able to withhold a potentially life-saving option because there are theoretical risks associated with it. But aren't there risks associated with *any* new medication, or really any medication period? I know the vaccine is new and there are risks and I still got it. I also know we don't know the long-term effects of COVID. So the same question remains: under what legal standing does a nurse have the authority to refuse to administer a vaccine after a provider and patient have already evaluated and discussed the risks vs benefits for that individual patient?

For me an easy way to evaluate this is to use the same logic in another setting - can I refuse to bring a patient to the OR because I believe the risk of surgery outweighs the benefits of extending an already diminished quality of life for my critically ill patient in his 80's?

I don't think a nurse should refuse to give any wanted therapeutic treatment, even if the risks might seem to outweigh the benefits. 

Thats for the patient to decide upon. Or their surrogate, or guardian, etc. 

Its not in the nurses job description to ever make medical choices for someone else. 

If a nurse disagrees with the job description, then maybe they should find a place to work that doesnt require them to fulfill those particular duties. 

[DallasRN]

On 4/9/2021 at 10:59 AM, spotangel said:

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!

I just copied and pasted this so as to be certain everyone read it.  To me, this is the essence of nursing. Thank you, spotangel.

[DallasRN]

On 4/9/2021 at 10:44 AM, SafetyNurse1968 said:

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

Personally, I would refuse the J&J vaccine due to the multiple issues they've had with this vaccine.  I really didn't understand why anyone would want it in the first place due to the shortened effectiveness period.  I would not refuse to give it if this was a person's vaccine of choice. 

Beyond that...

"The symptoms were “consistent with known common side effects,” the county said. In clinical trials, the most common side effects of the Johns on & Johnson vaccine were headaches and fatigue, followed by muscle aches, nausea and fever.

Of the 18 people, 14 were treated onsite, while four were sent to a local hospital, the county said."

Don't you wonder if the "side-effects" aren't similar to a "herd immunity" type of thing? Lots of press, lots of talk about that particular vaccine issues (blood clots, etc)...could this lead to anxiety/panic reaction resulting in the noted sx of headache/fatigue? One person faints, another, and another....And frankly and truthfully, I'd be afraid of J&J after all the bad press.

I was working in a low income senior facility recently.  Fire Department administered Moderna to all residents who wanted a vaccine.  A few days later, almost every single person talked about side effects necessitating bed rest, visits to doctors. In the meantime, I've talked to many others in the community who received Moderna who reported no side effects or only slightly uncomfortable muscle aches, sore arm, etc. I find this sort of stuff interest.  

[DallasRN]

On 4/12/2021 at 8:42 AM, 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. 

Oh my gosh!  These comments really triggered me big-time!  Who are you to suggest a nurse can refuse to give a vaccine to "a person who is medically considered 'old-old' I.e. over 85 *and* frail*. I personally know many "old-old" and "frail" people who are enjoying life, enjoying grandkids, enjoying laughter and friendships.  As a youger person, getting in your car and driving to work may "indeed be dangerous" but should I take your keys away from you?

 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.  Still their decision.

The symptoms were “consistent with known common side effects,” the county said. In clinical trials, the most common side effects of the Johnson & Johnson vaccine were headaches and fatigue, followed by muscle aches, nausea and fever.

Of the 18 people, 14 were treated onsite, while four were sent to a local hospital, the county said.

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.  I can't imagine any nurse injecting anything into a site with a staph infection.  Another arm is usually available.  If not, ask your supervisor - can I use the thigh or buttock for this vaccine? 

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  

IMO, you are trying to make ethical and moral decisions for patients and family members that you don't have the right or authority to make.  If someone was "in a vegetative state" or otherwise and family wanted a vaccine it still isn't up to ME to determine they should not receive it.  I would confer with and/or defer those decisions to my social workers, physicians, managers. Ethical issue.

I'm almost 72 and continue working in a clinic for senior citizens.  Am I next on the list to be frefused certain types of healthcare because I'm "old-old"?  We have a large group of volunteers that handle our reception desk, assist with b/p clinics, handle our equipment lending room...the oldest is almost 81, all are over 70, many retired RN's.  Active, vibrant, dynamic seniors!  

 

On 4/12/2021 at 8:42 AM, Gillyboo said:

 

 

[JKL33]

18 hours ago, MaxAttack said:

The argument here is that a nurse should be able to withhold a potentially life-saving option because there are theoretical risks associated with it.

No it isn't.

The question involves whether or not a specific nurse must participate.

As it stands right now, there is no reason to think that a patient's successful receipt of a covid-19 vaccine is dependent upon a single/specific RN.

I have several times explained why I believe that RNs who wish to refuse to give the vaccines are outliers and don't have a big effect on vaccine administration.

For all any of us know 99.999% of the people who answered this poll aren't even going to be in the position to be asked to administer the Covid-19 vaccine in the first place. You know? Who cares what they think.

People are getting quite upset over something that certainly seems to me like a significantly far-fetched hypothetical.

I have no clue and no way of knowing, but I would still bet that at least 50% of the people who answered this poll have not been asked to administer a covid vaccine and don't even work in a setting where their role involves administering the Covid-19 vaccine. Random guess.

 

18 hours ago, MaxAttack said:

For me an easy way to evaluate this is to use the same logic in another setting - can I refuse to bring a patient to the OR because I believe the risk of surgery outweighs the benefits of extending an already diminished quality of life for my critically ill patient in his 80's?

How do you think that would play out? That's just it for him?  He dies right there and you are accused of single-handedly "refusing [him] life-saving surgery"?  Your manager calls you in and terminates you for "shouldn't even be allowed to call yourself a nurse" while the guy dies?

Know that if you are able to handle yourself (and your concern about the old guy) professionally, our code of ethics does allow for that, and it is for everyone's good. And that's really the crux of my entire argument.

 

[Avill, BSN, RN]

'Should a nurse be allowed to refuse to give vaccinations? Why?'

No they should not. Our jobs as nurses is to respect every individual patients desires, regardless if we agree or not.  

For example, if I have a 96 year old patient with lung cancer, and he doesn't want to quit smoking, then by all means I did my part by educating and it is not my job to tell them what to do. 

Also, don't take a job that goes against your morals/ethics. For example, if you are against contraceptives, don't work in a family practice clinic.  
 

[Surfin USA]

On 4/12/2021 at 11:01 AM, MaxAttack said:

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?

None, whatsoever. 

And I would surmise that the covid vaccine has had about as many atypical reactions as any other vaccine that HAS been FDA approved. Some people get temporary bells palsy from a vaccine. Some have an anaphylactic reaction. Not many. It's rare, but it happens. It just sounds very common right now because thats the main topic of discussion. 

I also (shamefully but) honestly DO kinda bully people into going ahead and taking the vaccines, mainly because I want this pandemic to end. 

My son was real sick last year and we thought he had Covid but we don't know. He was denied a test even. But he was really sick, and it nearly scared me to death.

Maybe he was having an allergy though. We just don't know. 

So he cant wait to get his vaccine. IDK if hes a good candidate, RN. He just had surgery last week.  

So we are holding off for a bit. Hes mostly at home just trying to recover, besides going to appts. It's bad. No fun. 

Are people in surgical recovery with a broken bone still good candidates for the vaccine?

He also just had a dTap..