Recently, I asked my chiropractor if he had received his Covid vaccine. He said no. He and his assistant do wear masks, but they see patients in a small room with a closed door. When I asked him again several weeks later, he said: “Well, we have to talk. I am not going to get the vaccination. I don’t believe in vaccinations. My family and I are all healthy and see no need for it.” On my way out, I asked his assistant if she had been vaccinated, and she replied: “No, and I don’t plan to. It’s a personal decision.” I called the next morning to explain that I wouldn’t be coming back to their practice because they weren’t vaccinated. Later that day, the chiropractor called and asked me if I would please respect his privacy and not tell anyone else about his decision not to be vaccinated.
I was appalled. Isn’t this an unethical request? He is a health care provider during a pandemic. Shouldn’t his patients be aware that he has chosen not to get a vaccine, as recommended by the C.D.C.? Doesn’t his personal decision affect others in a potentially dangerous way? By asking me to hide his decision, doesn’t he make me an accomplice to his duplicity? Name Withheld
A number of questions have recently arisen about how we should negotiate a social and professional world in which vaccination against Covid-19 is both common and contested. What’s clear is that many people think that getting vaccinated is simply about protecting yourself. And we do have what a philosopher would call a reason of prudence for getting vaccinated — a reason that’s more compelling the older we are. Yet there’s also a public-spirited, altruistic reason for getting vaccinated: There’s now bountiful evidence that vaccinated people are much less likely to transmit the virus to others.
When masks were first recommended, medical authorities emphasized their benefits not to the wearer but to others; only after some months, and additional studies, was it made plain that masks helped both parties. It’s the opposite story with vaccines. Vaccine approval depended on trials designed to show benefits to recipients, so officials were at first hesitant to say what now is clear: that they help others too. The broader point is one I’ve made before: When many people accept a small inconvenience — like wearing a mask or getting vaccinated — we can achieve something of great value to us all.
Getting vaccinated is more than a good idea. It’s an act of civic responsibility.
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.
And note that the C.D.C.’s recent “at ease” guidance for the vaccinated is predicated on the unvaccinated’s maintaining proper vigilance. When an unvaccinated health care worker caused an outbreak in a Kentucky nursing facility this March, residents who were vaccinated enjoyed a relatively high level of protection, but 18 became infected nonetheless, and one died. The elderly seem at particular risk for “breakthrough infections,” to be sure. Still, when people choose to be unvaccinated, they have chosen to increase the risk to others.
I should mention that chiropractic has a long association with anti-vaccination sentiments. Its founder, D.D. Palmer — who maintained that his theories were communicated to him by the spirit of a long-deceased physician — rejected the germ theory of disease, which disposed him to be skeptical of vaccination. Although many contemporary chiropractors do believe in vaccines, vaccine skepticism appears to be more common among chiropractors than it is in the medical mainstream.
Moving from the chiropractor’s ethics to yours, I’d point out that he didn’t tell you about his decision in confidence, which means you don’t have a duty to respect a later request to stay mum. Why does your chiropractor want you to keep this to yourself? Maybe he thinks that clients might drop him out of an irrational assessment of the risks — and some clients might. But that really is a personal decision.
I plan to get an implant procedure at my local oral surgeon’s office. I have stringently observed all social distancing and masking recommendations for the duration of the pandemic and made the appointment only after I could receive a Covid vaccine. At the office for a consultation, I asked the doctor if he, too, was vaccinated. He told me that he was. I then asked one of his assistants, who was about to perform a preliminary procedure on my unmasked mouth, if she was also vaccinated. I did so politely, but she was visibly offended, told me that it was none of my business and left the room.
Is it unethical for me to inquire about the vaccination status of medical professionals who carry out procedures that require them to be in close proximity to my unmasked face? Vaccines have been widely available in my state for weeks, and medical staff have been eligible for months. The only reason this person would not be vaccinated is because she is opposed on spurious ideological grounds. Given that the vaccine is not 100 percent effective, exposure to unvaccinated people still carries some risk. Furthermore, exerting pressure on the surgeon to require his employees to be vaccinated furthers a social good by encouraging herd immunity. I believe that vaccines should be a condition of employment in close-quarters medical settings. Is that an unreasonable expectation? Name Withheld
Your expectation is indeed reasonable (allowing for medical exemptions and the like). Let’s be clear: Assuming this woman was observing the proper protocols, the risks to you were very low, even though they would have been still lower were she vaccinated. In short, I don’t think you had serious reason to worry; I do think you had a right to ask. You’re entitled to assess what risks you’re willing to take, and her vaccination status is relevant to that assessment.
Why, then, did she storm off? Possibly she thought it was your inquiry that reflected a “spurious ideology.” Influential voices — a few on television and a great many online — encourage the belief that the dangers of infection are wildly exaggerated and that liberal indoctrination lies behind the vaccination campaign. A result is to spread the pernicious myth we’ve been discussing: that vaccination is merely a “personal decision.” Here we find one of the great lessons of the past year. If a pandemic may call for social distancing, an infodemic may be helped by social media distancing.
Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include ‘‘Cosmopolitanism,’’ ‘‘The Honor Code’’ and ‘‘The Lies That Bind: Rethinking Identity.’’ To submit a query: Send an email to email@example.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.)