DO’s and DON’ts to discuss face masks and COVID-19 vaccinations with patients
DO’s and DON’ts to discuss face masks and COVID-19 vaccinations with patients

DO’s and DON’ts to discuss face masks and COVID-19 vaccinations with patients

“Should I wear a face mask?”

“Should I get a COVID-19 vaccine booster?”

These are just two of the many questions and concerns that doctors and other healthcare providers often encounter when discussing face masks and COVID-19 vaccines with patients. The following guidance is intended to provide some suggested practices for physicians when involving patients in these discussions.

Encourage patients in areas with high COVID-19 community levels to “mask up”.

According to the current guidelines of the Centers for Disease Control and Prevention (CDC), all persons 2 years of age and older, regardless of vaccination status, living in areas with high COVID-19 community levels should be masked in public. The CDC also recommends that people at high risk for serious illness and immunocompromised in areas with medium COVID-19 community levels talk to their physician about taking additional precautions in public, such as wearing a mask.

The CDC’s recommendations at the COVID-19 Community level do not apply to healthcare. Healthcare should continue to monitor community transmission rates and follow the CDC’s recommendations for the prevention and control of infections for healthcare environments. Currently, most areas across the country and almost all of Michigan are currently considered to have significant or high transmission of COVID-19.

Encourage patients to be vaccinated.

Based on CDC and FDA guidelines, patients should be encouraged to receive the COVID-19 vaccine to help build protection against the virus. Physicians should advise patients who are not candidates for vaccination due to medical conditions on risk mitigation strategies, such as wearing face masks indoors, social distancing, and hand washing.

Encourages qualified patients to receive COVID-19 boosters.

When recommending booster doses to patients, reassure patients that the vaccines are effective, but research has shown a slight decrease in protection over time. Remind patients that booster shots are normal for vaccines, such as the annual flu shot or Tdap booster every 10 years. COVID-19 boosters offer increased protection and have worked well against most variants. According to the latest CDC guidelines from February 2, 2022, the following individuals are currently eligible for a booster dose of the COVID-19 vaccine:

  • Individuals 12 years of age and older who completed their primary Pfizer-BioNTech vaccination series at least 5 months ago.
  • Adults 18 years and older who completed their primary Moderna COVID-19 vaccination series at least 5 months ago.
  • Adults 18 years and older who completed their primary COVID-19 vaccination series at least 2 months ago for J & J / Janssen may receive a booster dose.

For further recommendations regarding eligibility for COVID-19 vaccines, specific clinical considerations and warnings, visit

Interim Clinical Considerations for the Use of COVID-19 Vaccines Currently Approved or Approved on the United States Website.

Use effective communication tailored to the patient.

Physicians are a reliable source of information for patients, and you should share accurate, clear, and easily accessible information that addresses common questions. To encourage patients to be vaccinated against COVID-19, it is important to listen to patients’ concerns. Professional answers to patients’ questions and concerns matter and can help them make an informed decision about receiving the vaccine.

Physicians should consider using words that will resonate better with each patient. For example, when discussing the benefits of COVID-19 vaccination, explain the safety of the vaccine and the benefits to the patient and his or her family. Physicians should also be transparent to patients, such as discussing potential side effects of the COVID-19 vaccine or the effectiveness of cloth versus other types of face masks in preventing COVID-19 transmission indoors or in crowded locations.

Physicians should avoid using judgmental language against people with face masks or vaccine problems, which can have a negative impact on patient confidence and the overall physician-patient relationship. In addition, it may be more effective to share facts about face masks and the COVID-19 vaccine as opposed to personal opinions.

Continue to implement COVID-19 policies and other infection prevention measures recommended by the CDC and MDHHS.

The CDC continues to recommend that medical practices and facilities apply additional infection prevention and control practices during the COVID-19 pandemic, including, but not limited to, medically appropriate telesealth visits, screening of patients and visitors entering the facility for signs and symptoms of COVID -19, and implementation of source control measures, such as face masks.

If a patient or visitor objects or refuses to adhere to the COVID-19 policies of the practice, such as refusing to wear a face mask, physicians should ensure that its policies include a protocol to explain the CDC’s guidelines for healthcare professionals that may differ from mandates or guidelines for individuals, and that a patient must adhere to the policies while inside the facility. If necessary and appropriate, the patient’s appointment may be rescheduled for a telesealth visit, or the patient may be referred to another physician for treatment.

DO NOT routinely terminate patients who refuse to receive the COVID-19 vaccine.

It has been reported in the media that some doctors refuse to treat unvaccinated patients. In other cases, some physicians have refused to treat children based on parental vaccination status, although the American Pediatric Association advises against refusing to treat pediatric patients based on parental vaccination status or position. In general, a doctor can legally freely decide who is to be treated and to terminate the doctor / patient relationship with appropriate prior notice. Until a consensus is reached on any potential ethical, licensing, or liability risk exposure that physicians may be subjected to by routinely refusing to treat persons who are unvaccinated or due to the vaccination status of others, physicians should consider making treatment decisions based on facts and circumstances. each situation.

YOU must implement a process for handling patients’ demands for medical exemptions from the COVID-19 practice policies that apply to patients.

Medical practices are generally considered public accommodation sites and must comply with the federal U.S. Disability Act as well as Michigan’s Disability Act when enforcing the practice’s own COVID-19 policies. Physicians must have a process in place to accommodate requests from patients and visitors for exemptions from the practice face mask mandate or similar policies based on medical reasons and to assess whether reasonable adjustments are possible. Physicians should not assume that a masked patient or visitor cannot medically tolerate a face mask or adhere to other COVID-19 policies, but physicians are permitted to accept the verbal representation of the patient or visitor in that direction. Best practice does not recommend requesting medical documentation from the patient or visitor to determine if the patient or visitor has a disability that justifies a reasonable adjustment.

DO NOT give face mask or vaccine waiver letters or documentation to patients who are not medically necessary.

Several media sources have reported on several physicians who have been disciplined by various state medical boards to issue medical exemptions to patients without an objective medical basis for the exemption. Some physicians are individually opposed to policies that impose face masks or COVID-19 vaccinations. Other physicians may empathize with patients who may be adversely affected by their refusal to comply with mandatory COVID-19 policies, such as a patient who may face termination of employment unless the patient receives the COVID-19 vaccine. Either way, physicians should not try to help patients circumvent COVID-19 policies that apply to patients by preparing letters or other evidence regarding the patient’s medical condition that is false or misleading.

This is for informational purposes only. It does not communicate legal advice from the Michigan State Medical Society.


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