What did your family discuss at Easter dinner? Mine discussed whether or not vaccine passports and asking for negative test results violates HIPAA policy….

Good times…

Broadly, HIPAA states that patient’s medical records are not allowed to be shared without consent of the patient.

Fine.

Any individual is allowed to share there medical history. If someone asks if you have been vaccinated you can share that information.

Do you have to share the information? No. But any venue has the right to refuse entry based on whatever their rules are. But is it legal to discriminate against someone because of their medical history? Or lack thereof…

For arguments sake: can you refuse entry to someone who is pregnant? Someone who has a disorder that requires medication? Does vaccination fall under the same umbrella?

Does a venue have the right to ask you about your medical history, or is that privileged information?

I really have no idea how scenarios like this will play out in court. I’m guessing it depends upon the judge and what evidence is put into play, which precedents…

But roughly speaking- what do you think about this?

Can someone demand proof of your medical records?

Pros and cons.

Discuss

81 thoughts on “Anything Can Happen Friday: Vaccines, privacy, HIPAA and you”

  1. What is decided within your borders is one thing, but to go to another country during a global pandemic with no end in sight, expect to be asked for proof that you’ve been vaccinated!

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    1. That’s a whole different thing. Any country can ask anything of you. But in America, can CitiField actually ask you about your health records?I don’t know the answer.

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      3. I know. I don’t even understand how many major American businesses owe other countries huge tax dollars amounts compared to what they owe the United States and don’t have to say what countries they owe it to

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  2. We know that international travelers must show proof of specific vaccines to enter specific countries. This has been normal for some time and they can be refused entry or face other consequences so I think a precedent has already been set that an individual can be asked to show proof. Can an entity/country search for those records themselves-no. That’s the point of HIPAA and protected PHI. The patient can choose to share, but is not required to share knowing they may not be allowed entry. I work with PHI at my job. We have Covid + mothers on the floor regularly who have given consent to viewing medical records. Because her baby is exposed, our policy in my specific job function is to bring a baby back to our unit after 2 weeks for the hearing evaluation. We state clearly that an alternate person who has no exposure must bring baby. We allow the mother, but she must have a new Covid test and bring results to show she is negative. She will not be allowed back on the unit if she chooses not to do that. In short, we have to trust that the alternate person is being truthful about their status when they bring baby. We do not require them to test, nor do we ask them to show any proof of Covid status or vaccination. We COULD ask them, but then our patients (the babies) would likely never return. So this is our balancing act if you will, relying on patients to be truthful with the knowledge they have about the virus as it applies to our hospital policy. And, I must add, I cannot at that point legally go back to access mother’s medical record to check on vaccine status. That would need new consent on her part.

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    1. There are all sorts of intricacies that the average person is unaware of. I’ve been going to various doctors to find out why I had that episode a few weeks ago and I’m constantly signing that my records can be viewed by hospital personnel. I’m n my case, NYU has an app so that yesterday my ent was able to access all the notes and test results so he could tailor our appointment and make further recommendations. But clearly these are hospital settings. As for vaccines, I know when my daughter did a service trip to Costa Rica, she had to have proof of all her vaccinations plus some new ones. I am totally fine with any country protecting its citizens from disease or sickness. But in the private sector, which is what we are dealing with now….

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      2. New York now has a vaccine passport, but there’s already questions about how secure the site is, who can access it, who is looking at your information, QR code’s and hacking….I can see it’s going to explode

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  4. It’s a tricky topic. Obviously, as already pointed out, you have to be vaccinated already for school and travel. It gets trickier with a business. If we allow businesses to ask about vaccination and deny service for that we do open it up for businesses to ask other medical questions and deny entry for certain things or if you refuse to answer. It could be a slippery slope.

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    1. That’s exactly what I worry about. If you can ask about vaccines, what does that open you up to asking? Can they refuse entry based on a medical condition. Totally slippery slope of north handled properly

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  5. I would think if there are vaccination passports you would have consented to give the vaccine information when you applied for the passport, therefore no break in HIPPA. As for businesses, entities requesting if you have a vaccine passport that should be a yes or no question. This is tricky as it doesn’t necessarily mean you have or have not had the vaccine but it is implied. As for health records I would think the only thing on the vaccine passport will be your vaccine records and to me that would not be a big deal. No different than my employer asking/requiring my other vaccination records as condition for employment. On the flip side, If it is connected to your entire medical record then I would say that would definitely be a huge HIPAA violation. In Iowa we have a vaccination registry called IRIS. Once your vaccinated it goes to that database and if you want your vaccination records they can print it out certified. It is great for employment and overseas travel. I know my Covid vaccines are on it but not sure if it will
    considered internationally valid. It will be interesting to see how this all plays out!!

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  7. If someone is pregnant or has a heart condition or other medical condition that is not going to affect anyone else, I think it should be their decision to attend an event or travel somewhere. They can be made aware of the risks but no one else should be able to tell them where they can go or what they can participate in. I agree that it is a slippery slope from the technology side in regard to who has access to the information and how easily it can be hacked.
    HOWEVER, if someone is not vaccinated for Covid it can affect many others. I believe that it is ok to require proof of that to travel, attend events, enter certain venues, etc. I also think that proof of vaccination for measles or other highly infectious diseases that can affect others should be required. I guess it would take public health officials to determine which things should be required and for how long. For instance, I don’t think a flu shot should be required currently, and maybe in a few years we will be at a point where Covid is not so highly contagious and easily spread.

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    1. Here’s the thing…when the last time any of us to prove we were immunized against infectious diseases. There are a bunch of anti vax kids out there.if a pregnant woman comes in contact with someone contagious there’s a host of problems. And, with it being a card without picture, how do you prove you are indeed the one vaccinated? Plus all the other things I mentioned

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  8. The rules get blurry when something becomes a public health risk. You have to provide your vaccination record for you child before they can go to school because it is a public health risk to have vaccinated kids attending school. I see this situation to be along those same lines, but on a much broader scale.

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    1. The problem is, we haven’t been asked to provide proof of vaccination to go to sporting events before. There have always been anti Vaxers who haven’t been immunized against certain things, yet they’ve been allowed to attend public venues. This flies in the face if that

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      1. Not really. Since vaccines are required to attend school in the US, the understanding is that enough of the adults in attendance at these events should be covered to prevent a major outbreak so the need for proof is unnecessary. You do not have that with the current virus. That is the very reason why kids are required to have them before attending school as it is usually their first time in larger group settings where the spread of infectious diseases can occur. There is precedent, it just looks a little different because this is effecting us at all ages and not just as kids, so it effects what we do at all those different ages as well.

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      2. But, the anti vax movement has been going on for at least 20 years. Which means that there are probably a decent amount of anti vax kids who are now adults. Add in religious exemptions. Add in people not schooled in the US. Then how do numbers look? But, at the end of the day, is it legal? Will it be challenged? And if the ID cards don’t have pictures, how do you know it’s actually that person?

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  9. I have no idea how the vaccine passport will play out.
    Nursing students(and other health related majors) have to show proof of vaccination, including the yearly influenza vaccine(where I live) to their colleges/universities. I’m assuming once we have enough supply they will all be required to show proof of the COVID-19 vaccine.
    As a nurse I have had the opportunity to have both COVID vaccines. It isn’t required by my employer though. I have a supervisor that says that people that refuse to get the vaccine should expect to be wearing masks and face shields forever.
    Regarding pregnant women—amusement parks discourage pregnant women from certain rides–I don’t know if they actually refuse to let pregnant women on the rides though.

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    1. I’m guessing the pregnancy thing is against being sued if something were to happen. I get the whole school kids need to be vaccinated thing, though I wonder if there’s a religious exemption. That I’m not sure. My daughter has never been required to get a flu shot either, so how this plays out is anyone’s guess

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    1. School is a different animal. For example…I’m going to a met game on April 25. I’m required to show my proof of vax, and since I won’t have cleared the two week window I also need to have a test. I’ve been going to citi field since 2009 and never have I been asked to show proof of vaccination. Do they have the legal right?

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      1. Agree, school is a different animal, but so is a world wide pandemic that almost took down our world economy? It is an invasion of privacy, no question. Risk assessment? There’s so much false information, and unknowns, it’s hard to make an informed decision.

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      5. I’m not sure if they have a legal right—but I guess laws could change.
        OTOH—if the venue wants to stay operable and not be accused of spreading COVID maybe they have to find a new way of doing business.

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  11. Prepare to be in public health passport purgatory for an extended period. There is no political will, currently, to agree on naming an honest broker, be they ad hoc or an existing entity, to tackle this task. Is it a “commerce clause concern? A federalist free for all? As mentioned here, a HIPAA hello?

    Or will national politico’s just punt it back down to state and local, when it all get’s too vocal, and choruses begin to sing about that mark of the beast, or some scheme concocted by your tribe or mine.

    More mass Masked confusion, even as technical solutions, for most anyway, could be implemented relatively easily.

    So it goes.

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    1. It’s going to get pushed aside to state and local. Which will start a whole big traveler nightmare. New York requires proof, visit us at your own risk….and will we need laminated vax I’d cards with pictures (maybe they can put your voter registration card on the flip side) figured I’d give people something to think aboit over the weekend…

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  12. Having worked in the public schools I can easily confirm that many students coming in from out of country and in country at middle school and higher did not have the vaccinations needed. I remember that I worked with a teacher this past year who was 81 years old and was outraged. Of course, some of us may wonder why she is till working but she was in good health and that is her prerogative but not all students are vaccinated.

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  15. A great question. I have no idea. It seems to me like a business, organization, or institution, can ask, yet, for me, the question is, does a person have to actually divulge the information. I think not. Yet, I then think the business, institution, or organization can, if they choose, restrict access to what the person is trying to access. Hmmmm. In the private sector, this is “easier,” in the public sector, much more difficult. Civil liberty issues also abound in these scenarios. Interesting. Reflecting….

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      1. Mmmm. Yes, I think so, which connects to another thing I’ve been pondering, in regard to the legal issues that are now arising, and are going to continue to arise (and their ramifications) in the coming months and year. For instance, what do employers do about employees that do not want to come back to work. Meaning, they ask to work at home permanently, due to health concerns, etc. Lots of interesting times ahead…have a great weekend, LA.

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      2. We were at dinner last night and we were asking the same thing…what do companies do now that their employees might not want to go back to work. Lots of things there

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  16. Interesting topic. I see problems with the vaccine passport because it’s a slippery slope. For example, the largest demographic group who doesn’t trust the vaccine is the Black community for obvious reasons (Tuskegee). My husband’s assistant, who is Black, is terrified of the vaccine. Do we want to create different classes of people — those with freedom to live a normal life and a subset who can’t? I wonder if private businesses can be sued if someone traces COVID back to their locale? Could anyone get sued for getting the flu, smallpox or HIV?

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    1. See….you shouldn’t be able to because of HIPAA privacy laws. You’re not allowed to divulge who has it. And that’s an excellent point…do we want to create subsets of those who can do and those who can’t? Good point

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  17. As I am sure you are familiar with the fact that most colleges and universities require proof of certain vaccinations. A patient can share their medical history if they desire that is voluntary. As bleuwater brought up, it might start making distinctions that are discriminatory. Pregnancy as far as I know is not contagious.

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    1. But can they bar you because if something medical? That’s what I’m not sure. I have a friend with an autoimmune disease that isn’t able to get vaccinated on Doctors orders. How does that play in?

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      1. Good question, if it is under doctors orders then do they have to carry something that says they can’t get a vaccination? Long ago when we all got polio and small pox shots I can’t remember reading about people not getting them.

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      2. Well, there’s a difference between something that can be eradicated, and COVID, which acts more
        Ike a flu and will require boosters. Then you have the fact that people did what the government said….now…not so much

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  18. Interesting. We are going to the Giants game tomorrow and proof of vaccination and/or a negative covid test within 72 hours is mandatory for entrance. I have no problem with that. If you don’t want to get the vaccine, that’s fine but don’t risk MY health by attending an event with me. Pregnancy is not contagious so you are not risking the health of others. However, I have seen pregnancy warnings on some rides at amusement parks and even when pumping gas.

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    1. But if you’re vaccinated, is your health at risk? And then I bring up the measles thing. If someone is pregnant comes into contact with someone with measles, there could be damage to developing child. Do we ask for proof of measles vaccine? But, it comes down to, is it legal to ask someone about their health?

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  20. Is my dog entitled to HIPPA? I have to produce his vaccinations to take him to day care or kennel him overnight. Hmm.

    Okay, this is a serious topic, I know. We do have to show vaccines for schools (or give an objection on some grounds). But even then the unvaccinated still get to go to school. Do the other parents know how many unvaccinated children are sharing their child’s classroom? This is something I do not know about, clearly.

    Getting in a plane or the like might be legit, but where DO you draw the line? I have no answers, only questions.

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  21. Nope! Don’t think anyone has a right to my information! With that said, if they require it for entrance then it is my choice to participate or not. Everything has a price. I think it is a form of discrimination, pretty simple. Where will it stop? Hair color? Skin tone? Lazy eye? Really. It could get that stupid crazy but as long as they ask for something personal and people give it willing then pretty soon it becomes the norm.

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    1. See…that’s exactly what I’m afraid of. What is reasonable to actually ask. Once you ask for something medical that is technically deemed to be privileged information, does that set a very bad precedent? I think we must tread carefully here

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  22. I know. What about the people who.want to get into a basketball game but dont believe in the shot so they didnt get it? Is it.fair? Should these poeple.be.put in a non vaccinated section? I’m not sure. I cant speak for these people. I’m getting it so I can hug my mom and so I can fly. I haven’t hugged my mom in.over a year. I received my 1st dose last sat. Get my 2nd may 2nd. I cant wait to hig my mom. Shes been cancer free a year now!

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  23. I was briefly looking at other comments but didn’t see this one mentioned. Forgive me if it was. How do we feel about colleges requiring the COVID vaccines? I know some are. I had a conversation with my daughter about this on Thursday. I think it’s no different from requiring vaccinations as they did before…MMR, Polio. What are your thoughts?

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    1. I think there’s a precedent set when it comes to schools. They’ve always asked for proof of vaccination. And there’s procedure of who is allowed to see records, and there’s established protocol. Now, can you fight that the vaccine has only been granted emergency status and is not fully approved? For now…yes…but in six months? Not so much. Now, it will be like a bouncer checking your privileged medical information. There’s lots of grey area here. But to actually answer the question…I think schools can ask for vaccination proof.

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  24. You are, I presume, talking about the USA. Quite clearly you will be sued for refusing entry to someone who doesn’t believe in vaccination as you are violating their human rights, which seem to include the right to do what they want, carry an assault rifle whilst doing it, and the right to infect other people with a deadly disease.

    One the other hand, if a sporting venue, or other large gathering allows people to become infected and die, will they be sued for failing to provide a safe place for the audience of the activity they provide?

    Regardless of science or common sense you are fated to become a battleground of legal argument for years to come. My advice is to avoid baseball games and spend the time studying to become a lawyer…

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  25. We should certainly push back against anyone demanding one’s ‘papers’; refusing service ‘bc they are a business, and businesses rule’; or compelling anyone have an (experimental, or indeed any) treatment they have not freely elected.

    Perhaps to cross a country border, or work in a medical field. But even to visit a facility, it is not *that* important we sell these products for these companies. Especially at some patient risk, & with barely evidence of partial immunity for ~6 months.

    This is not the zombie virus from world war z. & it is possible that there is no such virus, both stable enough & dangerous enough, for those kinds of measures. But at any rate: this one certainly is not it.

    JC

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