In an attempt to accelerate the distribution of the COVID-19 vaccine to the public, at least 20 states have allowed dentists to administer coronavirus and flu shots after the completion of the relevant training. The Minnesota State Senate was the most recent to approve such legislation on Monday. According to the American Dental Association (ADA), other states on the list include Alabama, California, Idaho, Nevada, New Jersey, New York, Ohio, and Washington.
Iowa is one of the states soon expected to decide on the proposed House Study Bill 71, which received its first hearing at a House subcommittee last month, but did not advance, as lawmakers needed more time to deliberate.
If passed, the bill would allow dentists to administer the shots after mandatory training on prescribing and administering vaccinations. However, the Register has noted that it will not permit the delegation of vaccine administration to dental hygienists or dental assistants.
With recent complaints concerning Iowa’s vaccine rollout, with many considering it too slow, and the state's latest expansion in group eligibility, the pressure is building on the administration.
A similar emergency bill was passed unanimously in Virginia, allowing any health care worker licensed by the Virginia Department of Health in the past 10 years and who is in good standing to volunteer for vaccine administration. This includes licensed practical nurses without supervision, as well as medical and nursing students.
Recognition at Last
Through their continuous advocacy efforts, the ADA and state dental societies have strived for the recognition of dentists as essential health care and vaccine providers. The dentists’ role in providing overall health care is finally starting to be acknowledged by local authorities and the general population, and most states have recognized dentistry as an essential service.
In October, the ADA House of Delegates passed Resolution 91H-2020, which states that dentists have the required knowledge and skills to administer critical vaccines to prevent life or health-threatening conditions and protect the life and health of both patients and staff at the point of care. The Resolution also mentioned that this expanded role for dentists was based on their appropriate clinical knowledge and competency to perform tasks in consistency with the prevailing health care standards. For instance, dentists have the required training to administer intra-oral and extra-oral anaesthesia injections, and in some states, even Botox injections or intravenous (IV) sedation. According to the Resolution, these skills can easily translate to vaccine and flu shots administration.
The pandemic is reducing the delivery of non-emergency dental procedures, highlighting the potential benefits of expanding the scope of practice to include vaccine delivery in dental practices, meaning dentists may finally cement their position in preventive health care.
However, before they can begin administering the COVID-19 vaccine to patients, dentists will have to complete a four-hour online training program from the Centers for Disease Control and Prevention (CDC). Other ADA vaccine principles include establishing patient relationships, following record-keeping requirements and falling under immunity statutes within the state.
A Tough Year
The outbreak of the coronavirus pandemic last spring resulted in the temporary closure of dental offices across the country for all but emergency appointments, thus leaving hundreds of thousands of Americans jobless. Although the majority of dentists have reopened, the number of visiting patients remains 20% below normal levels, according to the ADA. More than 46% of the dentists surveyed by the trade group reported that their patient volumes had decreased by at least 15% compared to pre-pandemic levels, despite the significant safety measures in place. To make matters worse, as most people's smiles are not visible behind their masks, the ADA projects that spending on dental care could fall by 20% in 2021.
Furthermore, the ADA estimated that, on average, dentists are spending an extra $15 to $20 per patient to cover COVID-19 prevention measures, and some are passing those costs to patient bills in the form of fee hikes. The additional sanitization and cleaning time required for infection control, combined with social distancing restrictions, means that dentists are physically unable to see as many patients as they usually would. Consequently, family dental practices, particularly those unable to spread out PPE costs, are struggling the most, while nine in 10 dentists have applied for some form of financial assistance from the federal government during the temporary shutdown. If people’s continuous hesitation in visiting the dentist keeps the patient volume at the current levels for a few more months, dentists say they would seriously consider raising their fees—including for insured patients—along with implementing other cost-cutting measures and staff cutbacks or even selling their practices. Meanwhile, dentists are increasingly embracing new avenues for doing business, generating new customers and creating revenue opportunities. Apropos of the relative bills still under consideration in several states, an ADA poll showed that 3 in 4 dentists are willing to, or would consider, vaccinating patients.
A Win-Win Solution
The dental industry could benefit enormously from the proposed legislation, as expanding the scope of dental practice to include the delivery of COVID-19 vaccinations would almost certainly drum up interest and propel new dental business opportunities.
Moreover, it would promote the vaccine’s distribution and increase the number of people receiving it since dentists are widespread across the country. The existence of dental offices in rural areas where access to healthcare centers are limited may enhance the dentists’ ability to reach more people and, therefore, commensurately elevate the public’s overall health.
If dental professionals gain temporary or permanent authority to administer vaccines across the entire country, this will benefit every dental business and its patients while protecting dental office staff jobs and helping revive their communities’ economies.
Although refrigeration capability for safe vaccine storage and sufficient supply are details that still need discussion to determine this solution's sustainability, this scenario looks promising.
The country is trying to execute a massive immunization campaign with the sense of urgency that its people demand. If dentists can contribute to getting life back to normal as quickly as possible while simultaneously increasing their patient volume, it will be a win-win situation for everybody.