During the reign of Marcus Aurelius, in 165 A.D., a dreadful epidemic swept through the Roman Empire. An estimated one-quarter to one-third of the population died during the 15-year ordeal. Nearly a century later, a second great plague came to Rome. Bishop Dionysius described the events in Alexandria:
At the first onset of the disease, they [pagans] pushed the sufferers away and fled from their dearest, throwing them into the roads before they were dead and treated unburied corpses as dirt, hoping thereby to avert the spread and contagion of the fatal disease; but do what they might, they found it difficult to escape.
The early church made its mark during this period, caring for and nursing the sick. According to one historian, through this “miracle working” of basic nursing, Christians may have reduced the mortality in Rome by as much as two-thirds.
So, it is no surprise that as state and local officials seek help from churches during the COVID-19 pandemic, including using church properties as vaccine administration sites, congregations are again stepping forward. As churches do so, they can take advantage of certain legal immunities and take other precautions to avoid unnecessary legal liability.
“PREP” for action
In 2005, Congress enacted the Public Readiness and Emergency Preparedness (PREP) Act to legally immunize select persons against claims for loss caused by, arising out of, relating to, or resulting from the administration of covered countermeasures, such as vaccines. The Act protects select licensed health professionals who administer vaccines in accordance with standards set by the Advisory Committee on Immunization Practices (ACIP). The Act also protects those who supervise or administer a program for dispensing vaccines when in conformity with the several Declarations under the Act by the Secretary of the Department of Health and Human Services (HHS).
Compliance with the ACIP standards, Declarations, and local public health authority’s guidance is an important aspect of ensuring legal immunity for a church participating as a COVID-19 vaccination site.
Typically, this guidance identifies the persons who are prioritized for inoculation. Adhere to these priorities and avoid the temptation to prioritize others, whether or not family or church members or church leaders.
In addition, take reasonable precautions to facilitate the safe administration of the vaccine. For inoculation sites, this includes removing hazards in the right-of-way, ensuring proper lighting, adhering to US Centers for Disease Control and Prevention (CDC) protocols, and planning for emergencies, such as serious allergic reactions or other vaccination side effects.
The PREP Act applies only to covered countermeasures, such as vaccines, and has no bearing upon other countermeasures, such as social distancing, quarantining, or lockdowns. Damages that are not proximately caused by the administration of the vaccine are not covered by the Act. For instance, the Act may cover an injury sustained by a person who trips in the tent where the vaccine is administered, but not necessarily by a person who trips while heading back to her car after vaccination.
The PREP Act does not provide any immunity with respect to willful misconduct. Also, employment and other claims are not the subject of the PREP Act—just loss caused by the administration or use of the vaccine.
Some states have adopted additional protections against liability for health-care providers (including workers) assisting with the pandemic and, to a lesser extent, organizations that volunteer to serve as immunization sites. Churches may be able to benefit from these protections, too.
Regardless of these protections, churches should still consult with their insurer regarding coverage. Many insurers are now excluding COVID-19 from primary coverage, but some may offer supplemental COVID-19 coverage for a fee. Churches may be able to request a signed release, waiver, and indemnity (hold harmless) from any entity wishing to host a vaccination clinic on the church’s property. Bear in mind, though, that government agencies normally have sovereign immunity, meaning that there will be a statutory limitation on the value of most public indemnity.
Similarly, a church may request signed releases, waivers, and indemnities from individuals who receive vaccinations onsite. Though their enforceability is uncertain depending upon state law, releases should be:
- exclude intentional or reckless acts; and
- state the risks of vaccination and the limited remedies available to vaccine recipients under the PREP Act.
Licensed health professionals and others identified as authorized to dispense the vaccine alone should do so. Churches should insist that only such persons inoculate onsite. Malpractice risk arising from inadequate screening, warning, evaluation, inoculating, or monitoring is reduced under the PREP Act, but in an abundance of caution, leaders should consider allowing a third party (such as a local health authority) to inoculate rather than the church itself. By doing so, the church will also avoid handling and potentially compromising the vaccine.
Aiding the greater good
Service to the public generally involves risk. Consider the Christians who confronted the great plagues in Rome. Vaccinating or offering the church as a site for vaccination is no exception, but some combination of the PREP Act, state immunities, insurance, releases, waivers, and indemnities can materially limit a church’s legal liability. Consultation with legal counsel on the front end of the effort can pay dividends while the vaccination effort itself speaks to the public about the relevance of the gospel to a world in pandemic.