DEAR DR. ROACH: At a recent appointment I discovered that my nurse practitioner (about 45 years old) doesn’t plan to get a COVID vaccination as he says it’s unsafe and that all of us (vaccinated ones) are just guinea pigs. I tried to argue, but he was the one holding the needle!

He works for a very prominent orthopedic surgeon here in town, and I think most patients would be dismayed to learn of this position. As patients, do we have the right to know if our medical team is unvaccinated? Other than change doctors, how should we deal with this? — Anon.

ANSWER: Let me first be clear: The medical consensus is absolutely evident that the available COVID-19 vaccines are very safe and very effective at preventing infection, hospitalization and death from COVID-19. While it is dismaying to hear of nurses, nurse practitioners, physicians and other health professionals espouse a contrary view, the available science, with a year’s worth of follow-up data from the initial clinical trials of tens of thousands of patients, and over 250 million doses given, show that the vaccine is safe and effective.

As of the time of this writing, medical professionals are not required to be vaccinated. However, as a patient you have the right to expect a safe encounter with your medical team. In my opinion, medical professionals with face-to-face contact with patients are ethically obligated to get the COVID-19 vaccine unless they have a medical reason they are unable to do so.

Medical personnel have a right to privacy. As an individual, I do not think you can demand to know whether your health care personnel are vaccinated. However, they are required to use appropriate protective equipment (including masks and sometimes face shields) to protect you from them, which is much more important if the provider is unvaccinated. Personally, I would feel more comfortable seeing a medical provider in a setting where I knew vaccines were mandatory for all office staff.

In the case you mention, I think the orthopedic surgeon for whom the nurse practitioner works should know the wrong, unethical and unscientific advice the nurse practitioner is giving his patients.
DEAR DR. ROACH: I have chapped lips, and my condition is worsening since I moved to Florida. Is it possible the Florida sun causes a more severe reaction than in the north? Or is it a reaction to prescribed blood pressure medication and the sun? — D.G.

ANSWER: Chapped lips can happen in any climate, but is more likely in dryer, sunnier and windier conditions. The Florida sun is certainly stronger, due to the angle of the Earth, and that might be the whole answer.

However, there are medications that can make skin reactions to the sun more likely. Of the blood pressure medications, the diuretic hydrochlorothiazide — used very commonly by itself or in combination (usually abbreviated “HCTZ” after another drug name) — is the most common cause of photosensitivity reactions. Regular use of a lip balm with sunscreen (zinc oxide is a good choice) is likely to help. Some lip balms contain substances that can actually worsen symptoms in people with sensitive skin: Menthol, camphor and phenol cause an initial tingling and cooling sensation, but can irritate the skin and damage the outermost layers of the lips, preventing them from holding on to moisture. Avoid these ingredients.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.