When Someone You Love Won’t Get Vaccinated: Just Say No

You may be surprised — or you may not — that over the past few weeks especially I have gotten a lot of questions through email, text, Facebook, IM, etc., asking what to do about relatives, friends, and other loved ones who refuse to get vaccinated and expect the questioner to spend time with them. It often takes the form of:

• “My son and his family are coming to visit, and our dear next-door neighbor whom we have known for years would love to visit with them, but she says she has not gotten around to getting vaccinated and doesn’t know when she will,” or
• “My brother’s family is coming to town, and they want to see their new baby nephew, but they have decided not to get vaccinated,” or
• “We’re heading east next month on a road trip, and my sister-in-law would like us to stay at her house, but she and my brother both had COVID already, so they say they’re not getting the vaccine because they already have immunity.”

They ask:

• “What should I do?”

The short answer is:

• “Just say No.”

Of course, it’s a lot more complicated than that. When we talk about relationships that have gone on for years and family members whom we only get to see infrequently, the calculus certainly gets complicated. And frankly, when answering questions like these, I have to make sure to separate my own feelings of anger and frustration at people who are not doing what is in their own best interests, as well as in the best interests of the community, from the scientific facts. Here, however, I think everything is in alignment.

First of all, if you have people in your household who cannot get vaccinated, either because they are too young or because they have a condition where vaccination is not appropriate or is not effective, the decision is easy. We do not want to put someone in harm’s way when there is an easy and effective prevention for contagion which in this case is avoidance and vaccination. If vaccination has not happened among those for whom it is available, avoidance is the only other option. At this point, each of us then has to decide our own level of comfort with different stages of avoidance, whether that involves everyone wearing masks when together, only meeting outside, or not meeting at all. Whatever we decide, taking reasonable precautions for the vulnerable is the most appropriate and loving thing we can do, and no one should be faulted for it or made to feel guilty about it.

As far as the evidence around “natural” immunity vs. vaccine-induced immunity, modern vaccines always give a more robust, more predictable immune response than natural infection. While your loved one may have had a case of COVID recently, there is no way to tell what their own immune response was or whether it is even still present in any way that is effective without their undergoing a prolonged and expensive battery of tests. On the other hand, the response from the vaccines has been tested exhaustively for over a year now. It works. And it doesn’t hurt to get the vaccine after you’ve had the infection. If anything, it makes the immune response much stronger. As we all know, many people who have been diagnosed with COVID have gotten it more than once so it is entirely possible that the same thing could happen to your loved one while they are with you and your family, becoming a danger to all of you.

So while I certainly understand your dilemma, you and everyone in your family have to do what’s best for your family. This is especially true for children who are not yet eligible for COVID vaccines. These kids cannot mount their own internal defense, and it is a reasonable, prudent obligation of those around them to make sure that they are not put in harm’s way. And while kids generally do not get as sick with COVID as adults do, here are some sobering numbers:

• 4,000,000 American kids (under age 19) have been diagnosed with COVID since the start of the pandemic.
• Of those kids, 1/1000 have developed Multisystem Inflammatory Syndrome in Children (MIS-C).
• Of those kids, 1/100 have died.

The risk is small, but it is real. One of the simplest, most loving things we can do is to make sure that someone in our care who is vulnerable is not exposed to a person who has chosen not to protect themself, much less anyone else. And while this may make for some difficult conversations and open wounds in these relationships for the time being, we would also do well to avoid placing shame or blame on those who have chosen not to get vaccinated so far. If we can be clear that we are making these decisions based on the best scientific evidence and our love for our family — and our hope that they will also get vaccinated for their own safety and well-being — we can hope that everyone will at least remain alive and healthy long enough to repair that damage down the line.