The evidence supporting the effectiveness and safety of vaccines is incredibly strong (1). In addition, nearly 60% of the US population (2) is fully vaccinated and there has been no signs that vaccines are harming even a miniscule number of people, should in and off itself, be more than enough evidence to support the validity of vaccines. Moreover, research clearly shows that vaccinated individuals are significantly lower risk of infection and serious illness than the unvaccinated (3). Clearly, there is more than ample and obvious support for the value of vaccinations. Similarly, there is no evidence of harm associated with masking and sound evidence that masking reduces risk of infection (4). *
Sadly, despite the very strong and straight forward scientific evidence supporting the tremendous benefits of vaccination and masking both have become contentious social issues. Arguments against vaccination have ranged from the outlandish, we are being implanted with microchips, to the overtly political (the variations of political arguments against vaccines range from assertions of the right to control one’s body to suggestions that vaccines are part of governmental overreach and social control). Arguments against masking have a similar tone. A wide range of assertions challenging the value of masking (and even suggesting harmful effects of masking) have been made, (5) despite the fact that there is no evidence to support these claims and sound evidence to support the value of masking (6).
Our belief is that we need to respect the scientific evidence and adhere to the public health guidelines that flow from this evidence. Therefore, all of our staff who are in our offices (including office staff) are fully vaccinated and mask when interacting with each other, in shared/common spaces, and when working with clients. We also require all clients who are eligible to be fully vaccinated and where a mask, when in our offices. We will be extending this requirement to children 5 and older, when they are able to become fully vaccinated (January 1, 2022 is our current target date for extending our policy to include the 5-11 age group). Currently, all children, as well as adults, are required to wear a mask in our offices.
We firmly reject the arguments that we are impinging on individuals’ freedom to choose whether they wish to be vaccinated and/or wear a mask. First, no one is mandated to come to our offices. We are not forcing people to get vaccinated or wear a mask. Rather, we are insisting that if they wish to obtain in-person services from Centers for Family Change that they need to adhere to and respect our policies, and hopefully understand that our policies are based on scientific principles (as is our approach to therapy). Second, we do offer services to unvaccinated persons, via teletherapy. Moreover, we do not harangue unvaccinated persons about their status, but will offer education about the value of vaccination and masking, if asked.
We believe that all of us have a duty to consider the impact of our behavior on others. While adults can drink as much alcohol as they wish, they cannot drink to excess and drive as this behavior endangers others. There is a myriad of other instances where we all accept and honor limits on our freedoms to act as we feel/believe, and agree to not engage in behaviors that potentially place others at risk. In the case of Covid19 we all have an obligation to consider the health and safety of others, and take reasonable steps to avoid actions (or inaction) that would place others at risk. In fact, we believe that a greater awareness and consideration of the impact of our actions on others is something that should have greater salience in our society (which tends to highlight individualism over community).
Finally, we do not honor exemptions. We are not medical experts and cannot judge the validity of medical exemptions. Rather, it is our view if one has a medical exemption, one is at greater risk of illness (and of spreading illness) and we would recommend teletherapy for these persons. In terms of religious exemptions, our rejection of this exemption is not based on any disrespect or devaluing of others religious beliefs. Rather, it is based on the argument, perhaps best articulated by Steve Chapman, in the Chicago Tribune (7), that honoring religious exemptions is “a mistake.” Chapman notes that “no major faith bars followers from being immunized against disease.” He goes on to note that trying to gauge the validity of a religious exemption is a daunting task and not one that employers should undertake, or are qualified to judge. He also notes that many states, including more conservative states, e.g., Mississippi, do not allow religious exemptions for other vaccinations. From a legal standpoint, Chapman details that Federal courts have rule that there is no obligation exempt religious believers from laws that applies to others, including things such as paying taxes. Finally, he concludes by noting that the severity of the Pandemic calls for all of us to make accommodations to protect each other, and argues that we not entitled to “behave in grossly selfish” ways that endanger others.
In conclusion, we believe that our policy regarding Covid19 adheres to the guiding principle of health care: “first of all, do no harm.” By insisting on masking and vaccination for in-person services we are doing our best to reduce the risk of harm for those seeking in-person services (as well as for ourselves, our patients’ families, and our own families). Moreover, we have been committed to a scientific and evidence-based approach to treatment. To disregard science in terms of how we practice would be completely counter to our philosophy and approach to providing therapy services. Finally, we believe that we all have an obligation to consider the impact of our actions on others, and refrain from behaviors that place others at risk. This is true not only for Covid19, but for many aspects of our lives. We understand that not everyone will agree with our policies, but we firmly believe that we have the right and obligation to practice in a scientifically sound and safe manner.
- CDC data on the safety and efficacy of Covid19 vaccines: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html
- Mayo clinic Covid19 Vaccine tracking data: https://www.mayoclinic.org/coronavirus-covid-19/vaccine-tracker
- Per the CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html
- From the Journal of the American Medical Association, JAMA Insights: https://jamanetwork.com/journals/jama/fullarticle/2776536
- Reasons given that masking is harmful from Ballotpedia. org: https://ballotpedia.org/Arguments_against_mask_requirements_during_the_coronavirus_(COVID-19)_pandemic,_2020-2021
- Scientific support for the value of masking: https://www.pnas.org/content/118/4/e2014564118
- Steve Chapman op-ed, 11/7/21. Chicago Tribune.
*References 1-4 are from late November 2021.