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There is a peculiar situation right now where the Oxford vaccine is suspected to be more efficient if the first dose is a half-dose:

About 3,000 participants were given the half dose and then a full dose four weeks later, and this regime appeared to provide the most protection or efficacy in the trial - around 90%.
In the larger group of nearly 9,000 volunteers, who were given two full doses also four weeks apart, efficacy was 62%.

But lets say the regulators go ahead and approve the "two full doses" vaccine for distribution to the public, as the half-dose option didn't get enough volunteers. Sometime in March, I walk into CVS for my COVID vaccine appointment and a doctor/nurse is waiting for me with a plunger. Do I have the legal right to do one of the following?

  1. Instruct the nurse in advance that I would like to receive just a half-dose
  2. Wait until the plunger is half-way down, then yell STOP or yank my arm to prevent the full shot from being injected

In this situation my goal would be to receive the "half dose and then a full dose" and I'm curious to understand how I could do this without violating any laws.

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    I don't think this is a legal question unless you assume a government mandated vaccination. If the government just offers you can yell and mess around during medical procedures all you want. The doctor/ nurse might refuse to treat you but that is not a legal issue. – quarague Dec 8 '20 at 21:15
  • @quarague my question is whether I'm entering an implicit contract with the doctor to complete the injection once I let him insert the plunger into my arm – JonathanReez Dec 8 '20 at 21:21
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    You're probably not gonna get the Oxford vaccine in the US. (Otherwise this is a fairly funny question.) – Fizz Dec 8 '20 at 22:14
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    @Fizz: That, and "off label" normally involves a physician recommending the non-standard treatment, not the patient demanding it of their own accord. – Nate Eldredge Dec 8 '20 at 22:28
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    Another fun question is whether your insurance, government subsidy, etc, will still cover the cost of the treatment if you don't receive it as medically recommended. It may well not, in which case you'll probably get a bill for the full retail cost of the vaccine and its administration. – Nate Eldredge Dec 8 '20 at 22:32
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You can request in advance that you get only a half-dose: there is certainly no law prohibiting making a request. They may refuse or they may agree. If they refuse, you can go elsewhere, but you cannot compel them to do what you ask for, given current law. You can also yell anything you want, or flail about however you want, at your peril. You could seriously hurt yourself by jumping around, and you would not be able to sue them for your stupid actions. Nor could you sue them for assault, since to get the ball rolling, you have to consent to getting the shot. Although consent can be withdrawn, there is the practical matter that you almost certainly cannot effectively communicate withdrawal of consent in the time needed to finish administering the job. If it took 5 minutes to administer the shot, you might be able to say "I changed my mind", and they would be required to end the treatment, against medical advice.

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    If you injure yourself you can't sue them, but if you injure them they can sue you and/or request you be prosecuted. – dave_thompson_085 Dec 9 '20 at 8:03
  • I work in research imaging, if you hit the stop button, obviously it takes a minute to stop the magnet, and take you out. There are probably rules about safely finishing the action you're on when consent is withdrawn. I don't know if stopping a shot early is considered unsafe. OTOH, I certainly have gotten shots that I would have time to say "stop!" (My last HPV shot was injected veeerrry slowly.) – Azor Ahai -him- Dec 9 '20 at 15:13
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Practically, it's just not going to work to jump away mid-injection. Anyone with any practice at doing injections is going to press the plunger quickly enough that you're not going to be able to react at the midpoint. Instead you're just going to hurt yourself pointlessly.

The doctor can agree to give you a different dosage than the recommended one, though (in the US). The FDA specifically addresses off-label use of drugs including using a different dosage than recommended.

From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient.

which includes

Given in a different dose, such as when a drug is approved at a dose of one tablet every day, but a patient is told by their healthcare provider to take two tablets every day.

But you would need to get your prescribing physician to agree to that in advance and write your prescription for that dosage. You can't unilaterally demand an off-label usage (or even a specific on-label drug), at most you can request it. (Otherwise drug addicts would go in saying that they have a slight headache and they need narcotic-of-choice.)

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It wouldn't violate the law to ask the nurse/doctor to stop, or to physically move your arm away. However, yanking your arm while getting an injection isn't a good idea from a safety point of view.

You ask in a comment whether there's a contract. A contract requires mutual consideration and meeting of the minds. If you pay someone to inject something into you, the money is consideration going to them, and getting the injection is consideration going to you. Being allowed to inject it would not generally be considered a consideration going to them, and courts would be unlikely to support specific performance. And unless you knew, or reasonably should have known, that they were expecting to be able to inject it as part of their consideration, there would not be a meeting of the minds.

The general understanding on services is that the person receiving the service has the option, not an obligation, to get the service. If you buy a movie ticket but the theater refuses to allow you to watch the movie, you have a claim against the theater. If you buy a ticket and then don't show up, the theater doesn't have a claim against you.

A more complicated question is whether there is legal recourse against a nurse/doctor who doesn't comply with your request to stop the injection. Consent generally can be revoked, but it's unlikely for the government to pursue criminal charges in a case like this, and it would be difficult to pursue a civil case, as it would be difficult to show damages, and the defendant would argue that they were concerned for your safety.

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  • Even if it were a term of an implicit contract that the patient should receive an injection, with or without their continued consent, it seems very unlikely that a court would enforce it. Such a term would surely be void as unconscionable and/or against public policy. – Nate Eldredge Dec 8 '20 at 22:10
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    @NateEldredge: You're not getting specific performance out of such a contract, but you could surely get damages (e.g. if you tell a school or something that you have all your shots, and then there's an outbreak and it emerges that you lied to them). But CVS is not going to be a party to such a case. – Kevin Dec 9 '20 at 5:03
  • Acting "squirrley" or making sudden unexpected movements during any procedure is an excellent way to upset the medical professional doing the job and any support staff in the room assisting. Just ask the guy who did my vasectomy! In my defence, it was much more than a "slight pinprick" – Criggie Dec 9 '20 at 7:45

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