The unvaccinated will be coded




How will this information be used by insurance companies or the government?

(Brownstone Institute) – The CDC recently codified International Classification of Disease (ICD) codes for Covid-19 vaccine status. ICD codes are extensively used in medical records, medical insurance data and health research to classify precisely disease states as well as injuries from exogenous agents such as accidents, medication and medical device injuries, toxic chemicals, etc. Vaccination status is not a disease or an injury state, yet CDC has rationalized creating ICD codes for it. The coding is set to become effective on April 1, 2023.


As described by Dr. Robert Malone, “The ICD classification system is run by the World Health Organization, not the US government.”  The vaccine status ICD codes were developed by the US Centers for Medicare and Medicaid Services (CMS) some nine months ago, and CDC is implementing them.


The coding scheme, Z28.xxx, includes both vaccination status and possible reasons for the status. However, there does not appear to be a code for “fully vaccinated,” only for various states of “not fully vaccinated.”


The code Z28.0 means “immunization not carried out because of contraindication.”  Z28.1 means “immunization not carried out because of patient decision for reasons of belief or group pressure.”

2 means “immunization not carried out because of patient decision for other and unspecified reason.”

8 means “immunization not carried out for other reason” which because of code Z28.2 must refer to reasons not attributable to patient decisions.

Finally, Z28.39 means “other underimmunization status,” including “Delinquent immunization status” and “Lapsed immunization schedule status.”

However, a potential contradiction arises because code Z28.310 means “unvaccinated for COVID-19.”


In order to reconcile this, the Z28 codes in the previous paragraph must refer to vaccines other than for Covid-19. The only other Covid-19 code is Z28.311 which means “partially vaccinated for COVID-19,” where “partial” refers to the CDC definition for “fully vaccinated” at the time when the patient visits the health-care provider who records the vaccination status in the medical chart.


It is apparent that the details of reasons for patient choices for vaccine status are not specified in codes for Covid-19 vaccines, but the CDC has some two months to fix this. There are no specific codes yet for “refused to divulge COVID-19 vaccination status” or “unknown COVID-19 vaccination status,” but these codes are likely to be added at some point.


What is the usage for which this information is planned? There is certainly a public health rationale for agencies to be able to monitor population vaccination status. Personal health information is routinely analyzed by public health agencies, insurance companies and health researchers, but in anonymized and grouped formats. The identifiable information is recorded in the databases, however HIPAA and other laws strictly protect identifiable health information and regulate how such information may be used for analyses.


In theory, vaccination status could be no different. Medical records already know your age, gender and race, where you reside, about your obesity, diabetes, your smoking and alcohol usage and your HIV status. Some of this information could be stigmatizing if released publicly, but at present there are no politicized or other circumstances to force unwanted choices on members of the public based on this compiled personal information.


Imagine, however, that one day, government agents are pounding on your door at 6am, telling you that you are required to take smoking cessation medications, under penalty of forced residence in a “smoking-cessation hotel” until you submit to the government’s requirement.


The medications have built-in transmitters that are activated when exposed to stomach acid, so taking them is recorded. After all, 500,000 Americans die every year from smoking-related diseases and their end-of-life medical care is an expense for which the government no longer wants to pay. Your smoking is economically hurting the medical care that grandma needs. Or something.


But Covid-19 and its vaccination are different. The Covid vaccines and their boosters were created under emergency-use authorization (EUA) protocols and are not fully licensed. The Biologics License Application (BLA) versions, e.g., Comirnaty, are not generally available in the US. This licensing chicanery has not gone unnoticed by the American public and a substantial fraction of people find the vaccines controversial.