The magazine’s Ethicist columnist on why asking about vaccine status isn’t a question of etiquette but of public health.
My employer, a large university, recently instructed us in an email titled “Vaccine Etiquette” not to ask fellow employees if they are vaccinated. I feel I have an interest in knowing this information for two reasons: First, the C.D.C. offers different guidelines for the vaccinated and unvaccinated. So I need this information to know which guidelines to follow. Second, if we are engaging in behavior that creates risk (e.g., breathing in an enclosed space), I have an interest in knowing what the risks are, in the same way that before having sex with someone I have a cognizable interest in knowing their S.T.D. status. Most people would not consider asking a person their S.T.D. status rude when both parties are engaging in potentially risky behavior. Why is this different?
Do I have an ethical right to ask about vaccine status, even if it’s “rude”? Name Withheld
Given that our country has had roughly 600,000 pandemic deaths, I wonder whether “etiquette” is the most apposite term here. Use your flatware from the outside in; hold the door open for the person behind you — such is the usual remit of etiquette. But when public-health officials devise and promulgate guidelines that involve public health, they do not consult Amy Vanderbilt. As you note, the C.D.C.’s behavioral guidelines vary with people’s vaccination status. If someone may be increasing your risk of illness, you’re entitled to know. And if you’re entitled to know, you’re entitled to ask.
People, of course, may decline to answer, in which case it would be reasonable to assume that they have not been vaccinated. (Despite the claims of a certain Georgia congresswoman, I should add, HIPAA has no bearing on what you or your employer can ask; it restricts disclosures made by health care providers and insurers.) Getting vaccinated makes a person much less likely to transmit the virus, but if such transmission does occur, those most vulnerable to infection are the unvaccinated. So asking about someone’s status would show consideration for that person too. And of course, colleagues who are open with one another about their vaccination status are probably getting on better than those who aren’t.
Our vaccination status, with its bearing on our likelihood to contract and transmit infection, isn’t a private fact about our health — and its disclosure isn’t a mere matter of etiquette.
If your university doesn’t require vaccination for in-person presence, it shouldn’t be allowing indoor meetings that don’t involve masks, good ventilation and social distancing. The overall risks to the vaccinated may be small, but you’ll want to take account of the dangers to your elderly relatives, say, or to people in your circle who are medically vulnerable, or simply to your unvaccinated colleagues.
This whole conversation would become moot were we to reach herd immunity from the combination of the vaccinated and the post-infected. But the pandemic is very much not in the rearview mirror just now. That’s why our vaccination status, with its bearing on our likelihood to contract and transmit infection, isn’t a private fact about our health — and why its disclosure isn’t a mere matter of etiquette.
My son, who has a developmental disability, lives in a small group home in which most of the residents have been vaccinated against the coronavirus. Recently, the home was placed under quarantine because a resident or staff member was exposed to the virus, even though my son and others have been fully vaccinated for weeks.
I complained to the agency about the restrictive quarantine, which unnecessarily affects my son’s quality of life given his vaccine status. I also expressed concern about other potential Covid-19 exposures from unimmunized staff members or residents, which could result in future quarantines. I was told that vaccination is voluntary and that the civil rights of those who refuse vaccination must be protected. I understand that, but doesn’t this policy violate the civil rights of those who have already been vaccinated? Name Withheld
I can think of no moral objection to a facility of this sort making vaccination a condition of employment or residency if doing so would contribute significantly to the health and welfare of those at the facility and pose no significant risk to recipients. Both conditions are readily met in this case. Indeed, some developmentally disabled people may have a hard time complying with the measures — masking, distancing and so on — that are the other major means of preventing the spread of the virus. And by now a vast number of people have been vaccinated, while the history of vaccines tells us that what the C.D.C. calls “late side effects” are extremely rare. So we can be confident that our vaccines are safe as well as effective.
It’s probably best not to cast this in terms of civil rights, though. People usually use the term to focus on guarantees of equal protection or individual freedom. But it’s perfectly routine to have conditions on employment — whether training certificates or compliance with safety protocols. Well before the pandemic, a number of states required that health care workers be vaccinated against certain communicable diseases, and it has certainly been common for medical care systems to adopt such requirements. Group homes often have immunization requirements, too.
Of course, exemptions must be made for medical contraindications. But those contraindications (e.g., an allergy to polyethylene glycol, or PEG; or, with the Janssen vaccine, polysorbate; or a severe reaction to a previous dose of a Pfizer or Moderna vaccine) appear to be rare. There are people with weakened immune systems for whom vaccination may not work very well, but they are not thereby endangered by it.
A more complicated issue is raised by religious objections. These aren’t much found in the religious mainstream, to be sure. A handful of Catholic bishops have argued that the Janssen vaccine is “compromised” because its production involves a cell line, established three decades ago, that originated in aborted fetal tissue; they say parishioners should take one of the other vaccines if available. But most vaccinations on offer have been either Moderna or Pfizer, anyway; you could accept this stricture without eschewing vaccination. And the Vatican has judged the Janssen vaccine “morally acceptable.” More daunting are reports of evangelical churches that claim vaccination confers the mark of the beast. (Note, too, that the E.E.O.C.’s definition of “religious beliefs” includes “moral or ethical beliefs as to what is right and wrong which are sincerely held with the strength of traditional religious views.”)
Not all religious objections need to be accommodated, though. A requirement can be deemed a bona fide occupational requirement even if it effectively discriminates against people with anomalous views; and the same logic can apply to an institution’s residents, students or patients. We seek to accommodate religious (or religious-like) views so long as that accommodation doesn’t come at serious cost. When that’s not possible, it’s no expression of hostility to the religious to ask them to make accommodations. At least in the tradition I was raised in, this was understood. There were inconveniences associated with sticking to the demands of our faith. We bore them willingly as part of the service we were offering to God.
To submit a query: Send an email to ethicist@nytimes.com; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.) Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include “Cosmopolitanism,” “The Honor Code” and “The Lies That Bind: Rethinking Identity.”
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