Vaccine update for Oregonians

Because of new rules and regulations affecting those working in the medical and educational fields, I wanted to include a few bits of information for you all here.

If you are still having difficulty finding a site for your vaccination, or are not sure where to go for shot #2 (if you got Pfizer or Moderna), check this site to find clinics and pharmacies near you: https://covidvaccine.oregon.gov/

Over the past 8-10 months I have not been shy in sharing my views on vaccination. I am fully vaccinated. I support covid vaccination as a public health measure. As research has been accumulating for the last almost-year, it still appears that all vaccine options available to us are safe and effective.

Seeing the stats coming out of hospital covid floors and ERs is frankly disturbing. Being non-vaccinated is the new "preexisting medical condition." Current infections are hitting these folks very, very hard. I have been, and continue to recommend, that if someone is able to get vaccinated, then they should seek that option as a layer of protection.

with vaccine requirements come interest in exemptions

I want to share this information publicly, so that if you or someone you know is seeking a medical exemption for covid vaccination, you are aware of what your provider legally can and cannot do for you.

Let me say that my covid vaccine information is coming from the CDC, and indirectly from the vaccine manufacturers themselves (it's all there on the CDC site).

Medical exemption means that there is a medical reason that a healthcare provider recommends against a treatment, in this case vaccination.

In fancy medical terms is means you have a contraindication for getting vaccinated.

So let me share with you the contraindications for getting a covid vaccine:

• Severe allergic reaction (e.g. anaphylaxis) after a previous dose or to a component of an mRNA COVID-19 vaccine (Moderna or Pfizer-BioNTech) or component of Janssen (Johnson & Johnson) COVID-19 vaccine.
• Immediate allergic reaction of any severity to a previous dose or known (diagnosed) allergy to a component of the vaccine.

[Source: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html]

So there you have it, folks. Those are the medical contraindications.

Here is a nicely laid out table showing each vaccine and its ingredients:

[Source: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html Appendix C above and Appendix B below]

So this means that yes, I can write a medical exemption* if someone has had a documented anaphylactic reaction to any of the covid vaccines, or their ingredients.

Employers may add additional qualifying exemptions at their discretion, so for patients wanting to discuss a medical exemption at their visit, I am asking them to bring any relevant information from their HR so we can review this information together.

what about other types of allergies?

 
Being allergic to basically anything else under the sun that is not an ingredient of one of the covid vaccines is not a medical contraindication.

Even having had an allergic response to a different type of vaccine. This may be surprising for some, but the reason is that if there are completely different ingredients, then there is no reason to think someone is allergic to say a tetanus shot and one of the covid vaccines. Take a look at the table below for additional information.

yeah, but will you sign it anyway?

I haven't gotten this question yet from patients, but I imagine it's only a matter of time.

If you do not have one of the contraindications listed above, and your HR doesn't provide any other qualifying conditions you may meet,** then no, I will not sign the medical exemptions.

I say this for several reasons.

One is that a medical exemption is a formal medical recommendation i.e. a prescription. I'm giving a prescription not to vaccinate in this instance. Which requires a medical necessity, so now we're back at square one- proving the medical necessity.

The second point is that for me to falsify medical documents is fraud. That is very serious when you have a medical license to protect like I do. There are already many healthcare providers making fraudulent health claims out there, and are being investigated by government entities. For the health, sanity, and longevity of myself and my practice, I would very much like to not be among those ranks.

I'm not being "chicken little" about this. A colleague who I went to school with is currently waiting for her court date in jail, with the charge being falsifying vaccine cards. This is all very serious and I won't be committing fraud because someone asks me to. That just won't happen.

So if you can, get your shot.
If you can't, and we can document that, I can exempt you.
And if you're just choosing not to, I wish you the best and hope you are taking many additional safety measures. But please don't ask me to be a part of it.

Take good care of yourself, now more than ever,
Dr. Angela

* Presuming your place of employment does not restrict the type of provider who can sign them (i.e. such as saying only MDs and DOs can sign it).
** That's really up to them to decide if they have a list that is longer than the contraindications posted on the CDC. I will follow the rules set out for me. So if your place of work says that in addition to the CDC list, having an ingrown toenail is a contraindication, sure I'll sign your medical exemption form if you have an ingrown toenail.