Health Care Policy.
Covid-19 vaccine mandate for health care workers gained a lot of publicity towards the end of last year. It was very important to have a
Discussion Individual Right Versus the Collective Good
policy that would guide health care workers due to COVID-19 vaccine hesitancy that was rampant in all population sectors for different reasons. A regulation was established to ensure all staff who were eligible to receive a COVID-19 vaccine would do so by January of this year before providing any care or treatment (Centers for Medicare & Medicaid Services, 2021). It was the responsibility of companies especially skilled long-term care facilities to establish a policy that would ensure those who qualified to be exempted did so in alignment of the guidelines established by the federal laws.
Tension between Individual Rights and the Collective Good.
In the health care world, herd immunity has been promoted especially in community nursing. It is very important because with herd immunity not everybody but the majority of the people can receive vaccination that leads to immunity of a disease. This makes infection transmission to be unlikely leading to the entire population being protected. This would cover even those who are not eligible for vaccinations. It is therefore important for bedside staff to be vaccinated. However according to Farah, Breeher, Shah, Hainy, Tommaso & Swift (2022), there are major disparities in actual vaccination rates among different health care workers (HCWs). Advanced practice staff who spend the least amount of time with patients have statistically received the vaccines than nurses and support staff. The probability of an infected support staff spreading COVID-19 would likely be higher because the close proximity of proving care with activities of daily living like showers may not be completed with full personal protective equipment (PPE) in place.
There are HCWs who are hesitant to receive the COVID-19 vaccine. Bellanti (2021), refers a delay in acceptance or outright refusal of vaccines as vaccine hesitancy. Those staff members who decline to receive the vaccine even when they are eligible to get it cannot work in some hospitals or nursing homes. This creates a further challenge with staff shortage already being a major concern.
It is an undeniable fact that every person has a right to choose what goes in their body but it would not be wise to put people at risk if it was avoidable. To decline to get a vaccine because of misinformation, fallacies, or myths is unfortunate. This is relevant to the COVID-19 vaccine.
Ethical and Legal Considerations of the Policy.
There are different factors that surround the mandate for COVID-19 vaccination policy among HCWs. Perez, Paul, Raghuraman, Carter, Odibo, Kelly & Foeller (2022), point out the nature of HCWs make them have a high occupational risk for contracting and transmitting the COVID-19 infection after exposure. Legally and ethically it would therefore be fair to give them a priority to receive the vaccines first.
Getting to a point of herd immunity would also be critical. This is not achievable if the vaccine is not accessible on a global level. According to Hosseini (2021), one of challenges of COVID-19 vaccine is whether the manufactures of the vaccine can be forced to share information with competitors so that availability of the vaccine across the globe can be reached quickly. It would be ethically meaningful to look at infectious diseases as public rights instead of individual needs.
Education is key to knowledge. It is important to acknowledge vaccinations have been an important tool that has been used to contain some dangerous diseases in the past. According to Gurenlian, Eldridge, Estrich, Battrell, Lynch, Morrissey, Araujo, Vujicic & Mikkelsen (2022), it would be for the greater good to further educate HCWs on topics like virology and epidemiology.
Reference
Bellanti, J. A. (2021). COVID-19 vaccines and vaccine hesitancy: Role of the allergist/immunologist in promotion of vaccine acceptance. Allergy and Asthma Proceedings, 42(5), 386–394. https://doi.org/10.2500/aap.2021.42.210063
Centers for Medicare & Medicaid Services. (November, 2021). Biden-Harris Administration Issues Emergency Regulation Requiring COVID-19 Vaccination for Health Care Workers.https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care#:~:text=All%20eligible%20staff%20must%20have,beliefs%2C%20observances%2C%20or%20practices.
Farah, W., Breeher, L., Shah, V., Hainy, C., Tommaso, C. P., & Swift, M. D. (2022). Disparities in COVID-19 vaccine uptake among health care workers. Vaccine. https://doi.org/10.1016/j.vaccine.2022.03.045
Gurenlian, J. R., Eldridge, L. A., Estrich, C. G., Battrell, A., Lynch, A., Morrissey, R. W., Araujo, M. W. B., Vujicic, M., & Mikkelsen, M. (2022). COVID-19 Vaccine Intention and Hesitancy of Dental Hygienists in the United States. Journal of Dental Hygiene, 96(1), 5–16.
Hosseini, M.(2021). A Covid Competition Dilemma: Legal and Ethical Challenges Regarding the Covid-19 Vaccine Policies during and after the Crisis. Public Governance, Administration and Finances Law Review, 6(1), 51–63. https://doi.org/10.53116/pgaflr.2021.1.5
Perez, M. J., Paul, R., Raghuraman, N., Carter, E. B., Odibo, A. O., Kelly, J. C., & Foeller, M. E. (2022). Characterizing initial COVID-19 vaccine attitudes among pregnancy-capable healthcare workers. American Journal of Obstetrics & Gynecology MFM, 4(2). https://doi.org/10.1016/j.ajogmf.2021.100557
Thanks for the insightful discussion. From your discussion, I have learned that with herd immunity not everybody but the majority of the people can receive vaccination that leads to immunity of a disease. If enough people are vaccinated, it can create a ‘herd immunity’ that protects even those who cannot be vaccinated for medical reasons or because they are too young (Giubilini et al., 2018). For example, measles is highly contagious and can easily spread in a population that is not immune. But if most people in the population are vaccinated against measles, then the disease cannot spread as easily. That is because when there are enough people who are vaccinated, it becomes very difficult for the disease to find new hosts (people to infect). So even those who can’t be vaccinated (such as newborns) benefit from herd immunity. The decision about whether or not to get vaccinated for COVID-19 will be based on an individual’s specific risk factors and health history (Farah et al., 2022). However, most healthcare workers should consider getting vaccinated, as they are more likely than the general population to come into contact with people who are infected with the virus. The Centers for Disease Control and Prevention (CDC) recommends that all healthcare workers receive the vaccine for both seasonal flu and H1N1 (swine flu), as these viruses are similar to COVID-19 (Randolph & Barreiro, 2020). In addition, those who work in healthcare facilities should routinely practice good hand hygiene and respiratory etiquette to help prevent the spread of infection.
References
Farah, W., Breeher, L., Shah, V., Hainy, C., Tommaso, C. P., & Swift, M. D. (2022). Disparities in COVID-19 vaccine uptake among health care workers. Vaccine. https://doi.org/10.1016/j.vaccine.2022.03.045
Randolph, H. E., & Barreiro, L. B. (2020). Herd immunity: understanding COVID-19. Immunity, 52(5), 737-741. https://doi.org/10.1016/j.immuni.2020.04.012
Giubilini, A., Douglas, T., & Savulescu, J. (2018). The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue. Medicine, Health Care and Philosophy, 21(4), 547-560. https://link.springer.com/article/10.1007/s11019-018-9829-y
