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Dying Wish: A Case of Controversial Covid Vaccination Near the End of Life
Epidemiology ; 70(SUPPL 1):S270, 2022.
Article in English | EMBASE | ID: covidwho-1853979
ABSTRACT

Background:

This case describes the circumstances of an older woman and her daughter faced with the dilemma of whether or not to receive the COVID-19 vaccine at the end of life.

Methods:

Ms. V was a 90-year-old woman with past medical history of major neurocognitive disorder, asthma, and hypertension on home hospice after experiencing a rapid decline beginning in November 2020. By January 2021, she had significantly deteriorated with a prognosis of weeks. At this time, the COVID-19 vaccine had become available to high-risk individuals and their household members. Because Ms. V lacked capacity to make her medical decisions, her daughter and healthcare power of attorney, Ms. B, had to determine her wishes. Ms. V's goals were comfort care and to avoid hospitalization. Although she had worked as a nurse, she had declined her annual influenza vaccine in the past. However, Ms. B felt that her mother would have wanted to help her children and caretakers get the vaccine, which would only be possible if she got the vaccine first.

Results:

Extensive conversations with Ms. V's children, hospice team, and geriatrician were held utilizing the 4-box approach to ethical decision making.1 Ms. B decided that her mother would have wanted to receive the vaccine for the main purpose of also vaccinating her children, who both had advanced heart failure and were at high risk for complications from COVID-19. She received one dose of the Pfizer COVID-19 vaccine and died ten days later. Her children and live-in caregiver all received the Pfizer Covid-19.

Conclusion:

Although Ms. V had previously refused annual influenza vaccinations, her daughter felt that her mother would have gotten the vaccine to provide protection for her children and caregiver. While it was acknowledged that Ms. V would probably gather little immunity benefit from the vaccine due to her poor prognosis, her daughter felt that the benefits of the entire household receiving the vaccine outweighed any potential risks. Her family called this final act of protection her dying wish.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Topics: Vaccines Language: English Journal: Epidemiology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Topics: Vaccines Language: English Journal: Epidemiology Year: 2022 Document Type: Article