Covid-19 vaccine: Why this one question is so controversial

Hot Vax Summer has arrived — and so have calls to return to offices, schools, and anywhere else we gathered in the Before Times.

But current estimates of vaccine uptake and skepticism suggest that if there are ten people in your office, statistically speaking, two aren’t vaccinated. Which might make you want to ask who got their shot.

But how do you ask someone what their vaccination status is without offending them? Is it a HIPAA violation? Does that even matter?

“Vax shaming” is becoming a serious concern for some of the more polite among us. The term is essentially defined as the act of publicly calling someone out for not being vaccinated against Covid-19.

John Loike, a bioethicist in the Touro College and University system, tells Inverse that asking others about their vaccination status can feel like an invasion of privacy. But it really comes down to safeguarding the health and safety of everyone.

Inverse asked both Loike and David Reiss, a psychiatrist and Qualified Medical Examiner, how to navigate tricky questions about vaccination status without straying into vax shaming.

Can you ethically ask if someone has the Covid-19 vaccine?

Shortly, yes you can ask if someone is vaccinated in certain circumstances.

“The issue of vaccination for Covid is highly relevant if you are in close physical contact with the person,” Reiss says.

Reiss tells Inverse he envisages three scenarios in which someone might ask others about their vaccination status:

• You have a relationship in which you regularly share that kind of personal information, like with a family member, or close friend.
• You notice that someone around you needs medical attention; for example, if someone faints on the sidewalk.
• It is relevant to your own well-being and the well-being of others around you.

If you’re all trapped in an enclosed space together, breathing the same air, then you might feel compelled to know if your close colleagues are vaccinated.

In fact, some companies and other organizations are not allowing employees back to the office unless they can prove they are vaccinated, like Morgan Stanley. Importantly, this is not vax shaming.

“Why someone isn’t vaccinated isn’t relevant to your safety.”

Some of the people most vulnerable to Covid-19 also can’t get vaccinated because they’re immunocompromised. Children under 12 aren’t yet eligible to be vaccinated, either. And we still don’t fully understand how the vaccines guard against transmission (but what we do know is promising). Every unvaccinated person is a potential host for the virus to thrive, replicate, and mutate.

“This is not an invasion of the other person’s privacy nor impolite, but a realistic matter of protection of oneself,” Reiss says.

“If the other person does not understand that it is their problem, not yours.”

How do you ask someone why they don’t have the Covid-19 vaccine?

Asking someone if they are vaccinated is one thing, but both Reiss and Loike agree that asking someone why they’re not vaccinated is just unnecessary.

Reiss breaks it down for us: “Why someone isn’t vaccinated isn’t relevant to your safety.”

To stay safe, you just need to know if, not why. Asking why edges closer to offending someone, but it also strays into a gray area of medical discrimination.

“There are individuals who are immunosuppressed or have other medicals reasons that they can’t get vaccinated,” Loike explains.

“You can’t make them feel bad for that. If they come into your store, you can’t demand to know why they’re not vaccinated.”

If you are a business owner with a lot of people coming and going, then you can encourage people to wear masks and social distance inside.

You have the right to ask someone to leave if they refuse to comply with these rules.

Can your boss ask to see your Covid-19 vaccine card?

The law on what employers can and can’t ask of their workers varies from state to state, Reiss says, but ultimately, it comes back down to safety. (San Francisco ruled this week that all city workers must be vaccinated or they could be fired.)

“The general law in most states is that an employer may only ask about medical conditions or vaccination status if it directly impacts the specific job duties or safety of self and others on the job,” he says.

Covid-19 is absolutely one of those conditions.

“Whether or not someone has been vaccinated obviously does relate very directly to the issue of workplace safety, such that medically, an employer asking about vaccination status is appropriate with no room for debate,” Reiss says. So while you might feel icky if your boss asks for your vaccination status, you may just have to live with it — and get vaccinated if you aren’t already.

If you refuse to disclose your vaccination status, your employer can fire you because you may put the health of other employees and patrons at risk. This is exactly what is playing out now in Houston, Texas, where more than 150 hospital workers have either been fired or have resigned over the hospital’s vaccine mandate. It’s not vaccine shaming, it’s workplace safety.

Does asking about the Covid -19 vaccine violate HIPAA?

Are you at risk of violating the Health Insurance Portability and Accountability Act (HIPPA) law if you ask colleagues, fellow diners, or any random person if they received the Covid-19 vaccine? The answer is no:

They also do not have to answer, but there’s nothing illegal — or shameful — about the question itself.

This 1996 law states that medical professionals can’t disclose your medical information without your permission. That’s it, that’s the whole law.

Stop and think, and you will see what we mean: We routinely provide medical information to third-party companies that aren’t bound by HIPAA — that FitBit on your wrist, for example, feeds medically relevant data back to the company’s servers all day.

Vaccines, you might say, are different to step count or sleep quality. But if you attend public school or college, you will have to disclose your vaccination history as a condition of your attendance. The same is true of traveling to certain regions — some visas come with vaccine requirements, including those issued by the U.S.

Is it ever useful to “vax shame”?

“Vax shaming” is when you publicly call someone out for not being vaccinated for Covid-19. It happens often on Twitter and other social media platforms but it pops up in real life, too.

“There is so much misinformation along with true unknowns.”

The instinct to castigate the unvaccinated is understandable, especially if you’re worried about your own health or someone else’s, Reiss says, but it’s not especially effective.

“Considering that accurate medical information about vaccination for Covid is readily available, calling a person to task, ‘shaming’ them, or castigating them will serve no useful purpose,” he says.

Rather, it “is more likely to reinforce defensiveness than to encourage objective consideration.”

It may be more effective to share personal experiences about how beneficial the vaccine is for your life.

“What's really important is trust and education,” Loike says. “I have a lot of friends who did not want to get vaccinated. I sat down with them and told them what my opinion was and the hard data that it was based on. All of them got the vaccine.”

Whether someone changes their mind about vaccines may depend on what their prior belief is based on, Reiss says.

“There is so much misinformation along with true unknowns,” he says.

“I certainly have known people who have changed their minds when they are sincerely making the best decision they can and learn of new data, or realize that they were relying on data that has changed or is unreliable,” he says.

And if the unwillingness to be vaccinated for Covid-19 is actually more a matter of political allegiance not based on facts or rational thought processes?

“Good luck with that,” Reiss says.

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