With COVID-19 vaccinations beginning in the United States, we are entering a critical phase in this pandemic. And in this phase, once again, we have an opportunity to help our communities.
When the COVID-19 pandemic shut down much of our country in the spring, dentistry shut down with it but reopened soon after for urgent issues only. Given an already strong emphasis on infection prevention and control and the actions taken to immediately strengthen safety standards even more, the oral health industry was able to quickly pivot to provide safe and effective care as soon as offices could reopen.
In the past several months, dental offices have adapted to this new normal and returned to providing critical preventive care. And COVID-19 infection rates among dentists, a high-risk group, have stayed remarkably low.
Dentists rose to the challenge. A new challenge, getting millions of American vaccinated as quickly and safely as possible, now awaits, and dentists are an essential part of the solution.
Federal and State Guidelines
The Centers for Disease Control and Prevention (CDC) have already outlined and continue to update recommendations related to COVID-19 vaccines as they receive emergency use authorization from the Food and Drug Administration.
The CDC’s Advisory Committee on Immunization Practices (ACIP) has released recommendations for states as they submit individual distribution plans. To start, ACIP officially designated healthcare personnel, defined as “all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials,” as one of four key groups to vaccinate first.
Why? Healthcare staff are at extremely high risk for contracting and spreading the virus, given their proximity to patients. Once vaccinated, they also can play a critical role ensuring that the vaccine gets to as many people as possible.
Dental professionals are ready to work alongside other healthcare personnel to protect our patients and communities. Those who are able, with training, storage capabilities, and bandwidth, can and should be among the professionals administering the vaccine to those most in need.
In fact, draft state plan summaries on the CDC website seem to all include a section on “COVID-19 Vaccination Provider Recruitment and Enrollment,” and the federal Centers for Medicare and Medicaid Services recently recommended that states expand their list of vaccine providers.
There has already been positive movement to allow dentists to administer vaccines during this pandemic and thus include them in the first phase of vaccine recipients.
The Arkansas State Board of Dental Examiners recently approved a change permitting dentists to administer COVID-19 vaccines, and Massachusetts specifically lists dentists among several other professionals who can administer them.
The California Department of Public Health, meanwhile, has explicitly included dental teams in its Phase 1a of vaccine distribution. And, most states are reportedly considering allowing dental providers to administer the COVID-19 vaccine.
This Should Be a No-Brainer
Allowing these essential healthcare workers to perform a service they are able and qualified to perform could increase the number of vaccine administrators by the tens of thousands. Excluding these qualified providers may result in prolonging the crisis, either because dental providers won’t be protected or because many hard-to-reach Americans will struggle to find an appointment.
Unfortunately, dentistry seems to have been overlooked in some draft vaccination plans, both for protection from the virus and as key distribution aids. Also unfortunately, that’s a symptom of a larger problem.
For too long, oral health has been treated as an afterthought to overall healthcare, when the fact is that oral health is overall health. Poor oral health has a direct link to higher risks of chronic illnesses. That’s why dentists took extraordinary steps to ensure that they could return to offering safe, preventive oral health treatment during this pandemic. And there’s new evidence that preventive oral health care mitigates some of the greatest risks of COVID-19.
What’s more, dentists serving as vaccine administrators during public health emergencies is not a groundbreaking idea. In fact, it’s been done before. Dentists in states like Massachusetts and New York were deputized as vaccinators during the H1N1 swine flu pandemic in 2009 and 2010.
Other states like Illinois and Minnesota currently allow dentists to administer flu vaccines. Oregon goes even further with a 2019 law allowing dentists to administer vaccines more broadly.
Even if limitations on delivering vaccines persist, dental providers remain key to reaching millions of Americans over the course of this vaccine deployment.
What Dentists Can Do
Here’s how dentists can play an essential role.
First, ACIP guidance aims to ensure we distribute this vaccine as comprehensively and equitably as possible. Using Oregon’s and Houston’s plans as examples, this translates into prioritizing distributors such as safety net providers that reach “high target populations.”
Dentists see a wide variety of patient populations. On a yearly basis, more than 18 million people visit the dentist but don’t visit a primary care physician or other medical professional.
The DentaQuest provider network alone serves 30 million people nationwide, most of whom are Medicaid patients.
Community health centers, many of which have dental providers, are well positioned to serve as trusted public health access points for traditionally underserved populations. In fact, more than 12,000 Federally Qualified Health Centers (FQHCs) nationwide are intentionally located to be accessible to communities of color, which have been among the most impacted by COVID-19.
Second, state plans include a specific section on recruiting providers to administer the vaccine. In Washington DC’s plan, for example, “provider recruitment will focus on Tier 1 groups that are able to receive, store, handle, and administer vaccines.”
Many public healthcare settings like FQHCs and some dental offices have the equipment, storage, and medical office space that can easily be adjusted to house and administer vaccines in a condensed timeframe.
Third, ACIP recommends state leaders consider first offering the vaccine to healthcare staff required to be within 6 feet of their patients. As we know, to take care of patients, dental professionals are more likely to be 6 inches than 6 feet from another person.
Including dental professionals as COVID-19 vaccinators will also reduce the burden, and the necessary close contact, for hospital emergency departments and other medical locations.
Let’s expedite getting as many people vaccinated as possible in a safe and timely manner, and let’s rely on dentistry to continue providing essential care in our communities. Lives depend on it.
Dr. Monopoli is a clinical leader at the DentaQuest Partnership for Oral Health Advancement, one of the nation’s largest oral health organizations working to improve the oral health of all. He is a graduate of the Tufts University School of Dental Medicine. He received Master of Public Health and Master of Science degrees from the Harvard University School of Public Health. He also completed a fellowship in geriatric dentistry at the Harvard School of Dental Medicine and the Veterans Administration. And, he served as the dental director of the Office of Oral Health for the Massachusetts Department of Public Health. Presently, he is the executive director for grants strategy of the DentaQuest Partnership for Oral Health Advancement in Boston. He also works across the DentaQuest Enterprise and with external entities, including federal and state government agencies, academia, other health organizations, and community groups to establish, promote, and provide support to partnerships and collaborations that can impact positive oral health policy nationally. He is a past president of the American Association of Public Health Dentistry as well.