What happens when pharmacy law and patient care don’t align? As a pharmacist during the COVID-19 pandemic, you are dealing with balancing legal liability and vaccine administration daily through ever-changing rules and regulations. This week’s episode shares hypothetical patient cases that David Brushwood, pharmacist attorney, and Jake Galdo, clinical pharmacist review. Together, they'll address the legal and clinical considerations for common COVID-19 vaccine scenarios you face in practice – which can often be in conflict.
The following patient scenarios are discussed; David and Jake address what the right thing to do is from both a practice perspective and a regulatory perspective.
**This debate was recorded in September. FDA and CDC continue to update and change the COVID-19 vaccine recommendations, which may affect the legal and clinical considerations presented in this episode. However, this materials helps providers triage the next patient care conundrum
Hypothetical Scenario #1
A pregnant pharmacist refuses to be vaccinated despite mandates from the state and from the pharmacy.
Hypothetical Scenario #2
A pharmacist has become burned out from the long hours, stress of the pandemic, and staffing shortages. The pharmacist administered the J&J COVID-19 vaccine to a patient as closing. When billing after hours, the DUR showed “do not mix vaccines.” The pharmacist refuses to do further vaccines in the current conditions out of concern for patient welfare.
Hypothetical Scenario #3
A pharmacist decided to “take a break” when COVID immunizations began, saying “I have heard that the vaccine is worse than the disease, and I can’t do harm to patients.” The pharmacist has now requested a return to work and is claiming a religious exemption from administering immunizations.
Hypothetical Scenario #4
A new patient comes to the pharmacy and states they previously received ChAdOx1 nCov-19 in the UK but would like to get a dose of BNT162b2 now.
Hypothetical Scenario #5
A regular patient presents a ‘prescription’ to the pharmacy, and it states the following: “‘Patient’ has previously received J&J Covid vaccine. Unfortunately, she was a chemotherapy patient at that time. She has no measurable antibodies. I have recommended that she be vaccinated as is she’d never been vaccinated before. She should receive 2 doses of either the Pfizer or Moderna vaccine. Thank you.”
Hypothetical Scenario #6
A pharmacy’s staff all have young children (ages 5 - 7 years old). The staff conduct their own research, and they conclude that the mRNA vaccines are safe for young children. They consider using leftover doses of vaccine for their own children, as opposed to wasting these valuable doses.
Hypothetical Scenario #7
Your neighbor, a physician, has been caring for her elderly parents and children as her fulltime job. She was fully vaccinated in January during the first phase and comes in the pharmacy for a booster on mRNA1793. You know she is not immunocompromised.