Vaccine Card Processes Present Problems for Trans, Nonbinary People

While the prospect of vaccinations and potentially achieving a semblance of normalcy has been exciting for many folks, trans and nonbinary people have voiced their concern, referencing that they did not feel considered in the vaccine card process, according to a report from The 19th.

The publication talks to several trans and nonbinary people who said they felt they were being put into stressful situations where they are required to out themselves or use their deadnames. Some also said they feel they are being left out of data collection on COVID-19 vaccination entirely, essentially that trans people have become an afterthought.

Orly Mahoney was one of the individuals who talked with The 19th, a nonbinary medicine student who recounted the process of trying to amend the name on their vaccination card, finding once they began the process, no one at their primary care office or the clinic where they received their vaccination could assist.

“It was really a Herculean amount of work to change my name in all the ways that I needed to change my name. And this is one of only a couple things that remains a sticking point,” Mahoney says. “There’s just this perpetual feeling of unfinishedness … it shouldn’t be this hard.”

Mahoney ended up requesting a name change within the patient portal at Massachusetts General Hospital, where they also worked at the time, and printed their full vaccination record, along with their original name change document and CDC vaccination card. Because their vaccine card doesn’t reflect the name change, Mahoney says there is a persistent fear of being outed when presenting the card.

Trans and nonbinary people already have to deal with costly documentation changes and insurance processes for gender-affirming care and pharmacies, on top of COVID-19 vaccination records. The CDC also required CVS to collect sex assigned at birth for COVID-19 vaccines, which it says is part of data collection and to monitor trends in disease and vaccination.

“We do not provide guidance for how providers should seek information about sex or gender for the COVID response,” CDC spokesperson Jasmine Reed says in an emailed statement. She adds that people must work with state, tribal, or local authorities if they wish to change their name on immunization records.

The CDC also says on its website that, in general, collecting patients’ sexual orientation and gender identity is crucial to understand and meet the specific healthcare needs of LGBTQ people.

Sam Miller is a Chicago pharmacist who wrote the pharmacy resource for trans inclusivity, and he says that pharmacies should ask for gender identity and pronouns when they ask patients to disclose their assigned sex at birth.

“When we’re looking at vaccine hesitancy, too, we don’t want to have things on forms that are making patients uncomfortable,” he says.

He also points to the issues surrounding updating vaccine cards, saying that he can’t imagine why changing a name would be an issue if the patient has already legally changed their name. He says pharmacies often have software systems that don’t accept storing preferred names along with legal names, but Miller notes he has personally shredded old cards and written new ones for patients after mistakes like a wrong date.

“It’s a piece of paper. Let’s get a new piece of paper,” he says.