When nurses go rogue, it puts vaccines — and society — on a dangerous path

As vulnerable patients across the country scramble for scarce doses of potentially life-saving vaccines against COVID-19, residents of Coffey County face an additional obstacle: the nurses at their own county health department.

In a Jan. 4 County Commission meeting, Department Chief Lindsay Payer explained that her staff was unwilling to provide doses of Moderna’s mRNA-based vaccine. She falsely stated that the vaccine had been tested on only 45 subjects, when the treatment arm of Moderna’s Phase 3 study actually had approximately 14,000 participants who reached endpoints prior to the shot being approved by the Food and Drug Administration for emergency use.

Payer and her colleagues may have all of the best intentions in the world. Unfortunately, the implications of this medically unsound decision, if it goes unchallenged, should concern Americans beyond the borders of Coffey County and even outside Kansas.

Healthcare professionals are afforded a unique privilege when they receive medical or nursing licenses that comes with financial stability, prestige and an all-too-rare opportunity to help their fellow human beings. This privilege also comes with a responsibility to do so, especially when a provider accepts a position with a public health agency. On rare occasions, history tells of courageous healthcare workers who challenged orthodoxies and saved lives — such as FDA reviewer Frances Oldham Kelsey’s celebrated 1960 decision to block approval of thalidomide, a teratogenic sleeping aid and morning sickness drug.

There are also cautionary tales: the inability of National Institutes of Health virologist Bernice Eddy to block the defective, lethal Cutter polio vaccine from distribution in 1954. But these heroic women were scientific experts charged by federal authorities with ensuring the safety of the products they reviewed — not front-line clinical workers asked to administer a product whose safety had already been confirmed by the nation’s leading specialists.

Controversy exists over whether, and under what circumstances, healthcare workers may refuse to participate in interventions that they find morally wrong. So-called “conscientious objectors” raise values-based concerns about such interventions as abortion, contraception, assisted suicide, sterilization, circumcision and prescribing cannabis. Whether clinicians should be able to opt out of offering these services is the subject of debate — pitting the rights of providers to follow their own ethical and religious precepts against the needs of patients seeking access to care.

This is not such a case. If the Coffey County nurses refused on moral grounds to use vaccines derived from fetal tissue, for instance, that would raise complex ethical and legal challenges. But these nurses have not questioned the morality of Moderna’s vaccine. Rather, they object to it on empirical grounds related to safety and/or efficacy.

Allowing individual doctors and nurses to refuse to provide optimal treatment because of their own personal beliefs or private research on the safety of medications and vaccines sets our society down a dangerous path. What of other providers who decide they have doubts about new drugs for cancer or heart disease?

Historically, novel vaccines have not been risk-free. For example, a swine flu vaccine caused an epidemic of narcolepsy in Sweden. However, it is the responsibility of experts to weigh such risks against the nearly 400,000 American deaths from COVID-19. And then it is the right of individual citizens to determine whether or not to embrace their recommendations.

Even if outside nurses are hired to vaccinate the residents of Coffey County, Payer may have already done damage — or even cost lives — by scaring away members of the public with misleading information. Nurses are certainly welcome to reject the vaccines for themselves, although doing so places them at increased risk of debility or death. But by refusing to vaccinate others, they suggest to the public an expertise that, quite frankly, they do not possess. Scientific opinions conceived in an armchair, or a nurse’s break room, pose a danger to us all.