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OPINION: COVID Vaccination – An Ethical Versus A Legal Decision

By David Hoff, posted Jun 4, 2021
Last week I received an email from my dentist indicating an upcoming cleaning appointment. I called the office to confirm the appointment and requested that the hygienist who would be cleaning my teeth be COVID vaccinated. I was told by the receptionist that she could not tell me that due to HIPPA.

Most people would not be familiar with HIPPA unless they worked in human resources. I did for 25 years. HIPPA stands for Health Insurance Portability and Accountability Act. Its primary purpose is to protect the electronic exchange, privacy and security of health information. It requires an employer to protect an employees’ private or sensitive information.

So, what does this have to do with COVID and my request?

I was not asking for an employee’s personal information, but assurance as a patient that whoever would be cleaning my teeth will have been vaccinated. The receptionist checked with the dentist, who gave me the same answer. I in turn cancelled the appointment and do not intend to return to that dentist.  

Am I as a patient entitled to make that request? Absolutely. Now bear in mind, I did not ask whether a specific hygienist had been vaccinated. I asked that the hygienist who would do my cleaning be vaccinated.  

There is more to the story. I have struggled with gum disease for 40 years. I alternate every four months between a dentist and a periodontist to minimize the gum issues.

In December 2020, I had my four-month hygienist cleaning at the periodontist’s office. I had plans to spend my Christmas holidays in St. Lucia with my family. There were a lot of restrictions in making that trip, but we were going to get out of Wilmington and go to some place warm. One of the requirements was that I provide a negative COVID test within 72 hours of my departure. It was a requirement to get on the airplane in Miami.

I went and had the test at 1 p.m. and then went to my dental appointment at 2 p.m. The hygienist who cleaned my teeth was someone I had not seen before. Everything went fine. The following morning my periodontist called to tell me that the woman who had cleaned my teeth had tested positive for COVID several hours after my cleaning. I had to quarantine at home for 10 days. I had to cancel the entire trip and tell my son that he would have to spend Christmas alone.

The COVID test that I had taken just prior to my cleaning came back negative. I suppose I could have taken the chance and proceeded with my Christmas plans. I had the legally required negative test. Ethically I knew I should put myself in quarantine and not risk infecting others, which I did. I did not get COVID. This all occurred before vaccines were even available.  

So, what is my point? Vaccines are readily available. They are not legally required of people. 
In the May 25 New York Times Magazine, The Ethicist columnist Kwame Anthony Appiah had this to say: “So clinicians who tell you that vaccination is a 'personal decision, as if it doesn’t affect, and therefore concern, anyone else, are making an all-too-common mistake. Your chiropractor thinks the current health of his own family is all that’s relevant, because he’s not considering that he might infect an elderly stranger and cause her death. (One C.D.C. study suggests that a majority of Covid cases were transmitted by people who weren’t symptomatic at the time.)

"He isn’t very likely to do that at work, of course, assuming he’s taking the proper precautions, including masking and ensuring proper ventilation in the small room where he works. Even so, his clients would be still safer if he and his assistant were vaccinated. That’s why it isn’t a personal decision, in the intended sense. Getting vaccinated, for those without medical contraindications, is more than a good idea; it’s something we owe one another. It’s an act of civic responsibility."

Appiah’s example involves a chiropractor. In my opinion, a hygienist who has her hands in a patient’s mouth during a cleaning is in a far more intimate proximity.  

After my “former” dentist would not guarantee that the person he assigned to clean my teeth had been vaccinated, I called my periodontist for a referral of a new dentist. I called the referral dentist’s office and received the same response about HIPPA preventing them from making that guarantee. I thanked the person for their time and indicated that there was no sense in talking further.  

A couple days later, I mentioned this situation to my son who lives in Virginia. His dentist, and my former dentist (when I lived in Virginia), announced on her website that 100% of her office has been vaccinated.  

My former dentist’s hygienists have every right to not get vaccinated. They do not have the right to make that decision and then seek employment where they potentially put the lives of their patient/customers at risk.  

My son’s dentist to me is a Healthcare Hero. She provided leadership and direction for her employees. She has created the safest environment for her patients/customers and employees.

I still hope to find that person here in Wilmington. 

David Hoff is chief operating officer and executive vice president of leadership development for EASI·Consult.
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