--- title: My Brother Is Unvaccinated Because Our System Is Ableist description: Our medical system too often fails to work with the most vulnerable like my brother to make sure they're getting protected canonical: https://time.com/6114771/covid-19-vaccination-ableism/ author: TIME article:opinion: true article:content_tier: free article:published_time: 2021-11-08T21:05:21.000Z article:modified_time: 2026-08-04T07:51:51.487Z article:section: Ideas og:title: My Brother Is Still Unvaccinated Because Our Medical System Is Ableist og:description: Our medical system too often fails to work with the most vulnerable like my brother to make sure they're getting protected og:url: https://time.com/6114771/covid-19-vaccination-ableism/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltb4d5fd3e12f85c93/698a1ea8d07533ed2ce6c26c/GettyImages-1344323369.jpg?branch=production&width=1024&quality=75&auto=webp&crop=16:9 og:image:width: 1024 og:image:height: 576 og:image:alt: Vaccination Clinic Administers Booster Shots In California og:type: article twitter:card: summary_large_image twitter:title: My Brother Is Still Unvaccinated Because Our Medical System Is Ableist twitter:description: Our medical system too often fails to work with the most vulnerable like my brother to make sure they're getting protected twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltb4d5fd3e12f85c93/698a1ea8d07533ed2ce6c26c/GettyImages-1344323369.jpg?branch=production&width=1024&quality=75&auto=webp&crop=16:9 ---  # My Brother Is Still Unvaccinated Because Our Medical System Is Ableist > Sponsored content. 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Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ## Video: How Vaccination Affects the Risk of Long COVID [Watch (HLS stream): How Vaccination Affects the Risk of Long COVID](https://cdn.jwplayer.com/manifests/oMDuUUjl.m3u8) (2:10)  _Published 2021-10-15. In the pre-vaccine era of the pandemic, experts estimated that somewhere between 10% and 30% of people who caught COVID-19 had lingering symptoms of some kind and severity. Long COVID is the name adopted by people who suffer symptoms long after their initial infection._ by [Amanda Joy Calhoun](https://time.com/author/amanda-calhoun/) ## Amanda Joy Calhoun Nov 8, 2021 9:05 PM UTC  Safeway pharmacist Ashley McGee fills a syringe with the Pfizer COVID-19 booster vaccination at a vaccination booster shot clinic on October 01, 2021 in San Rafael, California. Marin County opened its first COVID-19 booster shot clinic inside a former Victoria's Secret store at Northgate Mall. Safeway pharmacist Ashley McGee fills a syringe with the Pfizer COVID-19 booster vaccination at a vaccination booster shot clinic on October 01, 2021 in San Rafael, California. Marin County opened its first COVID-19 booster shot clinic inside a former Victoria's Secret store at Northgate Mall. Justin Sullivan-Getty Images) by [Amanda Joy Calhoun](https://time.com/author/amanda-calhoun/) ## Amanda Joy Calhoun Nov 8, 2021 9:05 PM UTC A [recent study](https://journals.sagepub.com/doi/pdf/10.1177/13623613211039662) showed that adults with autism spectrum disorder, intellectual disability, and other mental illnesses are at higher risk of contracting COVID-19 and having more severe cases of the virus. Based on my brother’s experience, I know one reason why: ableism. “He needs sedation!” Mom explained to the medical team. “He is not going to tolerate you placing an IV. He may hurt someone!” My brother has limited verbal ability, so Mom spoke for him. The medical team tried to place the intravenous line anyway. My brother immediately began defending himself, hitting a nurse and scratching the physician. A medical tech walked by the hospital room, his beady blue eyes landing on my chestnut-skinned brother with a sneer. The medical tech did not see a struggling man with autism spectrum disorder—my brother—he saw a problem. “You need any help, doc?” asked the medical tech poking his head through the doorway. “No, we’re okay here,” the doctor responded. My brother froze mid-struggle. His deep brown eyes rested on the blue eyes of the medical tech. “Help, please,” my brother said clearly. When patients with autism access the medical system, it often fails them, as it does my brother. Physicians fail to give them the support they need to feel safe, and staff fail to give them the compassion they deserve. When I became a doctor, I watched colleagues sigh when a patient with autism was admitted. “Ugh, this is going to be a lot of work.” “Yes,” I replied, frowning at my colleague. “Yes, it is.” [2.2 % of adults](https://www.cdc.gov/ncbddd/autism/features/adults-living-with-autism-spectrum-disorder.html) currently have autism spectrum disorder. [1 in 3 people](https://pubmed.ncbi.nlm.nih.gov/27354431/) with autism have a severe form—and are minimally verbal—yet severe forms of autism [have been understudied](https://link.springer.com/article/10.1007%2Fs10803-018-3844-y). Adults with severe autism are even less studied, as the majority of research studies focus on children and adolescents with autism, leaving adults out of the picture. Patients with autism are more likely to have [other medical and psychiatric illnesses](https://pubmed.ncbi.nlm.nih.gov/25911091/), some of which could be averted or attenuated, [with preventative care. ](https://www.spectrumnews.org/news/adults-with-autism-are-at-risk-for-host-of-health-problems/) Yet, they are less likely to receive routine healthcare from vaccinations to dental care, and their [use of medical services declines](https://pubmed.ncbi.nlm.nih.gov/28292222/) as they transition into adulthood. Sadly, most healthcare providers are largely [unprepared and untrained](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647496/) to treat patients with autism, [leading to poor outcomes](https://www.spectrumnews.org/features/deep-dive/healthcare-system-failing-autistic-adults/). Even before the pandemic, my brother struggled to receive decent medical care. Once COVID-19 came, the medical system did not treat him any better. When the vaccine was rolled out, he was excluded even as I watched my parents (a physician and a pharmacist) relentlessly advocate for him to receive it. As his guardians, they make medical decisions for my brother because he does not have the ability to make choices for himself. Vaccine clinics turned my brother away because he would require sedation or a physical hold to tolerate a needle being stuck in his arm. His dentist, who routinely sedates him for his annual teeth cleaning and medical labs, did not know how to gain access to the vaccine. His primary care physician dropped the ball too, not even bothering to coordinate my brother getting the shot. I checked autism advocacy websites, full of helpful documents promoting vaccination in individuals with autism. There were no resources for individuals with autism who were denied the vaccine. I left voicemail messages for autism advocates, but never heard back. I reached out to an emergency department physician practicing in the area my brother lives, St. Louis, Missouri. She was a former medical school classmate and friend, and I was hopeful she could help. “I would balk at giving sedation for a vaccine,” she said. She went on to robotically relay the burden of vaccinating my brother, citing that she did not want to be liable if my brother hurt someone, that the emergency department was too busy to monitor someone receiving oral sedation for a mere vaccine, and that it was a “primary care physician problem.” “No, it’s my brother’s problem,” I responded. Plenty of reporting has been done about the [profile of the unvaccinated. ](https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/)But, the missing pieces of the story are the many unvaccinated individuals who have severe forms of autism spectrum disorder, intellectual disability, or other mental illnesses. How many individuals are unvaccinated because an ableist medical system has failed them? A recent study showed that individuals with developmental disabilities, like autism, are more than [three times likely to die](https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0051) from a COVID-19 diagnosis. Yet, there appear to be no studies documenting the prevalence of individuals with autism spectrum disorders, or other severe mental illnesses for that matter, who are denied the vaccine. It is offensive to speculate about why individuals with autism and other mental illnesses are more vulnerable to COVID-19 without considering the impact of ableism—without considering that they may be denied the COVID-19 vaccine because they need disability accommodations. To be sure, vaccinating adults with severe autism and other mental health disorders, would require additional staff, either to physically hold the patient or to ensure that they have no adverse reactions to sedation. And if the moral weight of discrimination due to disability does not sway you, then let’s look at the costs and benefits. If these individuals are not given special accommodations, and are denied the vaccine, they are [29 times more likely](https://www.cnbc.com/2021/08/24/cdc-study-shows-unvaccinated-people-are-29-times-more-likely-to-be-hospitalized-with-covid.html) to be hospitalized if they contract COVID-19, adding to the billions of dollars in healthcare cost and burden on medical staff. Primary care physicians should be spearheading this care coordination, no doubt, and the burden should not fall on emergency department physicians and staff. Additionally, the federal government should give additional funds to federally qualified health centers, enabling them to provide special accommodations for disabled individuals to receive the COVID-19 vaccine. The federal government could also provide additional funding to emergency departments, so they can get the staffing and support needed to administer the vaccine safely to disabled patients. Either way, the clock is ticking for individuals like my brother, and I hope that the medical system steps up to the plate soon. My brother is still not vaccinated, and he deserves to be. ## Transcript Doctors often talk about COVID-19 in either or terms. Either you get a severe case that could land you in the hospital, or you have a fairly mild case that clears up in a week or two. But for the thousands, if not millions of Americans living with long COVID it's not that simple. Long COVID is the label often used by people whose symptoms linger for months or even more than a year after a coronavirus infection. These symptoms vary from person to person, but common ones include fatigue, brain fog, shortness of breath and chronic pain. Doctors are still trying to understand why some people develop long COVID as well as how to treat it. Some experts think remnants of the virus linger in the body too long, causing lasting symptoms, while others think the virus can push the immune system into overdrive, essentially making it attack itself. But no one knows for sure. It's not even clear how many people have the condition. estimates range from 10% to 30% of unvaccinated individuals who get sick with COVID-19 which means millions of people could still be suffering. Now that vaccines are widely available, the situation is changing. vaccination lowers your odds of getting infected by the virus, which is the best defense against long COVID and the unlucky vaccinated people who do get infected have a lower chance of developing long COVID than they would if they were unvaccinated. New studies suggest but some people have gotten long COVID after a breakthrough infection and more will as time goes on. That means experts will need to keep searching for answers and treatments to keep both the vaccinated and the unvaccinated safe from this chronic condition. ```json [{"@context":"https://schema.org","@type":"OpinionNewsArticle","@id":"https://time.com/6114771/covid-19-vaccination-ableism/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/6114771/covid-19-vaccination-ableism/"},"headline":"My Brother Is Still Unvaccinated Because Our Medical System Is Ableist","datePublished":"2021-11-08T21:05:21.000Z","dateModified":"2026-08-04T07:51:51.487Z","description":"Our medical system too often fails to work with the most vulnerable like my brother to make sure they're getting protected","url":"https://time.com/6114771/covid-19-vaccination-ableism/","keywords":["COVID-19"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/bltb4d5fd3e12f85c93/698a1ea8d07533ed2ce6c26c/GettyImages-1344323369.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Amanda Joy Calhoun","jobTitle":null,"url":"https://time.com/author/amanda-calhoun/"}],"articleSection":"Ideas","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/bltb4d5fd3e12f85c93/698a1ea8d07533ed2ce6c26c/GettyImages-1344323369.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"Vaccination Clinic Administers Booster Shots In California","caption":"Vaccination Clinic Administers Booster Shots In California","creditText":"Justin Sullivan-Getty Images)","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/ideas/","name":"Ideas"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/covid-19/","name":"COVID-19"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/6114771/covid-19-vaccination-ableism/","name":"My Brother Is Still Unvaccinated Because Our Medical System Is Ableist"}}]},{"@context":"https://schema.org","@type":"VideoObject","name":"How Vaccination Affects the Risk of Long COVID","description":"In the pre-vaccine era of the pandemic, experts estimated that somewhere between 10% and 30% of people who caught COVID-19 had lingering symptoms of some kind and severity. 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