The COVID-19 pandemic devastated the world and the US in particular, where thousands of people fell victim to the disease. It is easily transmissible and can have rather grave complications, affecting several body systems and increasing the chances of mortality. Vaccination is a viable preventive measure, although skeptics either deny the disease’s danger or believe that the process is equally harmful to exist; still, some might have valid contraindications. The dilemma of whether to use a vaccine is especially agonizing for healthcare employees, who have professional obligations, personal opinions, and potential medical reasons for refusing to vaccinate themselves. Making it a requirement might be beneficial for those who lack any contraindications and their patients, despite the accompanying ethical issues.
A prominent reason to enforce vaccination is COVID-19’s contagious nature, which endangers both the medical staff and patients. It can be transmitted indirectly through objects, and the direct way is aggravated by the fact that droplets may be suspended in the air for hours (Lotfi et al., 2020). Moreover, asymptomatic individuals are common, contributing to the disease’s spread (Lotfi et al., 2020). While healthcare workers are likely to be diligent enough to test themselves, patients admitted for different reasons than COVID-19 will not always exercise the same degree of caution. The same applies to the act of wearing masks, which is already normalized for medical specialists, although other individuals may feel differently and consider the regulation a restriction of their freedom (Mello, 2020). The protection is also not absolute due to such factors as airtightness, improper use, and different scenarios (Hirschmann et al., 2020). For example, the risk of transmission is different depending on whether both persons follow the regulations or only one of them (Hirschmann et al., 2020). Thus, COVID-19’s contagious nature and the mask’s flaws make vaccination a sounder solution for healthcare workers.
COVID-19 is associated with numerous complications besides affecting the respiratory system, which may put patients at a greater risk. For instance, it can cause certain cardiovascular conditions, such as myocarditis, dysrhythmias, and heart failure, and exacerbate the existing health issues (Long et al., 2020). Therefore, an unvaccinated doctor working in cardiology will contribute to their patients’ mortality even if COVID-19 is not the direct cause. Homeostasis is also affected by the disease, leading to lymphopenia, coagulopathy, and inflammation, all of which can be particularly dangerous for people with specific conditions (Debuc & Smadja, 2020). Furthermore, the neurologic system can be impacted by COVID-19, causing acute cerebrovascular disease, Hemophagocytic Lymphohistiocytosis, and Guillain-Barré Syndrome, among other complications (Bridwell et al., 2020). Although they are seen in most patients regardless of their prior medical history, those with it will have more acute manifestations and a decreased chance of improve (Bridwell et al., 2020). Lastly, COVID-19 is associated with lung damage, inflammation, and alveoli reduction, threatening the lives of respiratory care receivers. (Rendeiro et al., 2021). Overall, healthcare employees who refuse to vaccinate put various patients at risk, even in unrelated fields.
COVID-19 threatens medical staff as well, and many died during the pandemic while performing their duties, which further aggravates the situation. Italy saw a significant number of positively testing healthcare workers and visible mortality among them., which occurred when no vaccines existed (Lapolla et al., 2020). Consequently, the outbreak worsened as fewer specialists were available to control the disease, prompting hospitals to recruit retired doctors and nurses (Lapolla et al., 2020). Generally, the country had to consider health providers’ safety, as much depended on them (Lapolla et al., 2020). The same predicament was shared by other countries, although the degree varied depending on preparedness, equipment, and testing (Hassanian-Moghaddam et al., 2020). An important sentiment is that healthcare employees are valuable during periods of stress, and their resourcefulness is unmatched (Hassanian-Moghaddam et al., 2020). A doctor’s death is not only a personal tragedy but a huge loss for the staff, as it takes many years to prepare a qualified specialist. The situation does not allow for such luxury, so any life is important for stopping the crisis.
A precedent for mandatory healthcare vaccination exists in Italy, which was an appropriate measure considering the level of mortality. Although the trend was already moving towards having most employees vaccinated, several regions demonstrated hesitation (Paterlini, 2021). The decision’s legality may be questionable, but it attempts to address the grave situation and emphasize a healthcare worker’s duties (Paterlini, 2021). Those who refuse to be vaccinated have other options, and the hesitation is generally among the younger staff (Paterlini, 2021). The experience suggests that the utilitarian approach can be instrumental in resolving similar public threats.
Other than contraindications, which are valid reasons not to be vaccinated, the biggest barrier to mandatory vaccination of healthcare employees is ethical issues associated with the act. Some question the existing vaccines’ effectiveness or lack sufficient information regarding their compositions, and forcing them to perform the procedure is theoretically a violation of personal rights (Di Gennaro et al., 2021). Moreover, a group of employees may refuse vaccination for religious reasons, which is relevant for spiritual care organizations (Di Gennaro et al., 2021). It may appear that the arguments against the act are strong, although they fail to consider one’s professional obligations (Gur-Arie et al., 2021). A healthcare worker’s crucial mission is not to harm patients, and the threats of COVID-19 signify that those who refuse to vaccinate are very likely to contribute to increased mortality (Gur-Arie et al., 2021). Such behavior also puts families, colleagues, and other stakeholders at risk, which is something that should be acknowledged (Gur-Arie et al., 2021). It is an issue of whether personal beliefs are more important than the public good, and healthcare employees often have to sacrifice the former.
Those who cannot be vaccinated for legitimate reasons may still help. They can hold remote consultations from home and educate aspiring specialists who will replace them in the hospital setting, as some of their duties cannot be fully replicated (Khunti et al., 2021). As COVID-19 is likely to persist, they will have to ultimately decide if healthcare is for them as similar situations may occur in the future. Teachers and other person-oriented professions had to face the same problem, so health workers are not alone. They all should remember their responsibilities and moral obligations and consider other options that align with personal beliefs.
COVID-19 is an unprecedented situation in many regards, making people adopt new lifestyles and accept strict regulations, and the general trend cannot bypass healthcare. Employees should acknowledge the dangers the disease poses and undergo any procedure that will benefit the patient, including mandatory vaccination. They are more aware than anyone of its effectiveness and necessity, and many rely on healthcare workers to guide them. If hesitation is demonstrated on the core level, society at large will also refuse to protect itself.
References
Bridwell, R., Long, B., & Gottlieb, M. (2020). Neurologic complications of COVID-19. The American Journal of Emergency Medicine, 38(7), 1549.e3-1549.e7. Web.
Debuc, B., & Smadja, D. M. (2020). Is COVID-19 a new hematologic disease? Stem Cell Reviews and Reports, 17, 4-8. Web.
Di Gennaro, F., Murri, R., Segala, F. V., Cerruti, L., Abdulle, A., Saracino, A., Bavaro, D. F., & Fantoni, M. (2021). Attitudes towards Anti-SARS-CoV2 vaccination among healthcare workers: Results from a national survey in Italy. Viruses, 13(3), 371. Web.
Gur-Arie, R., Jamrozik, E., & Kingori, P. (2021). No jab, no job? Ethical issues in mandatory COVID-19 vaccination of healthcare personnel. BMJ Global Health, 6(2), e004877. Web.
Hassanian-Moghaddam, H., Zamani, N., & Kolahi, A.-A. (2020). COVID-19 pandemic, healthcare providers’ contamination and death: An international view. Critical Care, 24(1), 208-209. Web.
Khunti, K., Kamal, A., Pareek, M., & Griffiths, A. (2021). Should vaccination for healthcare workers be mandatory? Journal of the Royal Society of Medicine, 114(5), 235–236. Web.
Lapolla, P., Mingoli, A., & Lee, R. (2020). Deaths from COVID-19 in healthcare workers in Italy—What can we learn? Infection Control & Hospital Epidemiology, 42(3), 364-365. Web.
Lotfi, M., Hamblin, M. R., & Rezaei, N. (2020). COVID-19: Transmission, prevention, and potential therapeutic opportunities. Clinica Chimica Acta, 508, 254-266. Web.
Long, B., Brady, W. J., Koyfman, A., & Gottlieb, M. (2020). Cardiovascular complications in COVID-19. The American Journal of Emergency Medicine, 38(7), 1504-1507. Web.
Mello, H. L. (2020). Innovation diffusion, social capital, and mask mobilization: Culture change during the COVID-19 pandemic. In J. M. Ryan (Ed.), COVID-19: Social consequences and cultural adaptations (pp. 131-149). Taylor & Francis Group.
Paterlini, M. (2021). Covid-19: Italy makes vaccination mandatory for healthcare workers. BMJ. Web.
Rendeiro, A. F., Ravichandran, H., Bram, Y., Chandar, V., Kim, J., Meydan, C., Park, J., Foox, J., Hether, T., Warren, S., Kim, Y., Reeves, J., Salvatore, S., Mason, C. E., Swanson, E. C., Borczuk, A. C., Elemento, O., & Schwartz, R. E. (2021). The spatial landscape of lung pathology during COVID-19 progression. Nature, 593(7860), 564-569. Web.