Two legislators are asking North Dakota's Health Department to end phone calls to residents that inform them of how and where to get a COVID-19 vaccine.
The state health officer in a response said immunization reminders are routine, callers are state-employed and trained on federal privacy law, and people can opt out of state-issued reminders.
Sens. Jessica Bell, R-Beulah, and Nicole Poolman, R-Bismarck, sent a letter to State Health Officer Dr. Nizar Wehbi on Tuesday about the calls, listing concerns with patient privacy and the role of state government in "personal health choices."
Both lawmakers said they had heard from constituents who were called and given information about how to get the COVID-19 vaccine. Poolman said the people she talked to said they had not been vaccinated and wanted to know how state government knew that.
"In order for the Department to initiate these calls, medical records must be accessed without the immediate consent from the citizens of North Dakota," the lawmakers wrote in their letter.
The senators asked a handful of questions regarding the calls in their letter to Wehbi, including what kind of confidentiality protections residents have, who is making the calls, what kind of training they have and what happens if the information used to make the calls is released.
The senators told the Tribune they understand the importance of educating the public about the vaccine, but they have concerns about North Dakotans' privacy protections.
Bell told the Tribune she wants the Health Department to stop the calls until it can answer the questions asked in the letter.
"This isn't about vaccines," Bell said. "It's about the proper role of government."
"I hope they would stop calling individuals and see it as a public campaign and not an individual one," she said.
Wehbi in a letter responding to Bell and Poolman said that since COVID-19 is still "circulating in our communities," people who aren't vaccinated are at the highest risk of contracting the disease and that vaccine reminders are not unusual.
"Reminder/recall outreach is a well-established, effective tool that has been used to increase immunization coverage rates for years," he wrote.
Letters also were sent to people 65 and older who did not have a recorded COVID-19 vaccine.
The patient information is in a secure database owned by the Health Department, and the contact tracers making the calls are employed by the agency, according to Wehbi. They either "have medical or public health experience or have been trained by those with medical or public health experience," he said.
The contact tracers also have been trained on HIPAA, which is a federal law that prevents health care providers from sharing certain information without a patient's consent, he said.
People can opt out of reminders on the department's website, but they also will opt out of all immunization reminders by doing so.
Wehbi also said he would like to meet with the lawmakers and discuss any concerns they might have.
As of Monday, 1,654 North Dakotans were contacted with a COVID-19 vaccine reminder, Wehbi said. Of those people, he said, 8.3% said they were already vaccinated, 15% said they "were not interested at all" and 8% said they were either planning to be vaccinated or planning to talk to their doctor. He did not state how the other 68.7% of those contacted responded.
Wehbi's letter also states that "The calls were completed today."
North Dakota has some of the highest rates of COVID-19 vaccine hesitancy in the nation, according to the U.S. Department of Health and Human Services. The percentage of the adult population that is considered by the state to be fully vaccinated has plateaued at less than 50%, according to the Health Department's vaccine dashboard. Kirby Kruger, director of the Health Department's Disease Control Division, has estimated the necessary threshold for herd immunity could be as high as 70% of residents.
One of the biggest reasons people are passing on the COVID-19 vaccine is fear of the side effects that can come with the shot, according to a U.S. Census Bureau survey. Some people and groups such as Health Freedom North Dakota have concerns about the safety of the vaccines. Overall, federal regulators have found the COVID-19 vaccines to be safe.
Reach Sam Nelson at 701-250-8264 or firstname.lastname@example.org.