The balance of safety and efficacy and the perception of personal risk versus overall benefit are at the core of acceptability of immunization practices. The known and potential benefits of a COVID-19 vaccine must outweigh the known and potential risks. ANA strongly recommends that registered nurses be vaccinated against COVID-19. However, we recognize that without a well-established safety profile, the risk-benefit analysis could be such that nurses choose not to be vaccinated. We do not believe nurses should be retaliated against if they do not choose to be vaccinated.