{"id":277824,"date":"2020-12-05T10:48:25","date_gmt":"2020-12-05T15:48:25","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=277824"},"modified":"2020-12-05T10:48:25","modified_gmt":"2020-12-05T15:48:25","slug":"come-for-your-eye-exam-leave-with-a-band-aid-on-your-arm","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2020\/12\/05\/come-for-your-eye-exam-leave-with-a-band-aid-on-your-arm\/","title":{"rendered":"Come for Your Eye Exam, Leave With a Band-Aid on Your Arm"},"content":{"rendered":"
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Across the country, these medical professionals say their help will be needed to distribute the vaccines to millions of Americans \u2014 and they already have the know-how. (File photo: National Cancer Institute\/Unsplash)<\/figcaption><\/figure>\n<\/div>\n

With multiple COVID-19 vaccines rapidly heading toward approval, optometrists and dentists are pushing for the authority to immunize patients during routine eye exams and dental cleanings.<\/p>\n

Across the country, these medical professionals say their help will be needed to distribute the vaccines to millions of Americans \u2014 and they already have the know-how.<\/p>\n

\u201cWhen you look at what dentists do, and how many injections they give day in and day out, I think they\u2019re more than qualified,\u201d said Jim Wood, a California state assembly member and dentist. \u201cIt\u2019s kind of a no-brainer.\u201d<\/p>\n

In California, the professional organizations representing dentists and optometrists are in talks with state officials to expand their job descriptions to include administering vaccines. Oregon has already begun training and certifying dentists to give vaccines. And at least half the states<\/a> have considered allowing dentists to administer COVID vaccines once they\u2019re available, according to the American Association of Dental Boards.<\/p>\n

That list is likely to grow, because the U.S. Centers for Medicare & Medicaid Services recommended in October<\/a> that states consider expanding their list of vaccine providers.<\/p>\n

The dentists and optometrists seeking permission to vaccinate patients against COVID-19 and other diseases argue that their help will take some of the pressure off hospitals and doctors\u2019 offices. It could also bring some extra money into their practices.<\/p>\n

\u201cEveryone in our specialized health care system should also play a preventive role,\u201d said Dr. William Sage, a professor of law and medicine at the University of Texas-Austin. \u201cPandemic or not, being alert to preventive health in any setting is a good thing.\u201d<\/p>\n

In November, Pfizer, Moderna and AstraZeneca announced that their COVID vaccine candidates delivered promising results in clinical trials, and that millions of doses could be ready before the end of the year. Pfizer\u2019s has to be stored at ultracold<\/a> temperatures, while Moderna\u2019s and AstraZeneca\u2019s can be kept at standard refrigerator temperatures.<\/p>\n

This wouldn\u2019t be the first time<\/a> health professionals other than doctors administered vaccines during a pandemic. Nursing students, EMTs and midwives in a handful of states were granted temporary and limited authority to administer flu vaccines during the H1N1 swine flu pandemic of 2009-10. Dentists in Massachusetts, Illinois, New York and Minnesota also were temporarily deputized as vaccinators.<\/p>\n

Since then, Minnesota and Illinois have adopted laws to allow dentists to give flu shots to adults. And last year, Oregon became the first state to allow dentists to give any vaccine to any patient<\/a>, whether a child or an adult.<\/p>\n

So far, more than 200 dentists and dental students in Oregon have completed the training course offered by the Oregon Health & Science University\u2019s School of Dentistry, with 60 others expected to finish by the end of December, said Mary Pat Califano, an instructor who helped develop the hands-on part of the training.<\/p>\n

Students spend around 10 hours in online classes. They then undergo hands-on training during which they practice injections on a shoulder pad before practicing injecting a partner with saline. They\u2019re taught how to counsel patients about vaccines and avoid injuring patients\u2019 shoulders when giving the shots.<\/p>\n

Once dentists pass an exam, they can register with the Oregon Health Authority and begin getting their staff trained to handle vaccines and procuring a fridge to store them.<\/p>\n

The goal, Califano said, is not to replace family doctors or primary care physicians, but to supplement them. The federal Agency for Health Research and Quality found that, in 2017, 31.1 million Americans saw a dentist but not a physician.<\/p>\n

\u201cWe just need as many people as possible to give flu shots and COVID-19 vaccines when they\u2019re available,\u201d Califano said. \u201cIf it happens that they\u2019re in a dental office, and that provider is educated and capable of giving a vaccine, why not?\u201d<\/p>\n

In California, the state dental association is exploring options for gaining vaccine authority, which would likely require the legislature to step in. This year, California passed a law allowing pharmacists to administer COVID vaccines approved by the U.S. Food and Drug Administration.<\/p>\n

Wood, who carried that measure, hasn\u2019t yet committed to sponsoring a bill that would let dentists give vaccines, but says he supports the idea.<\/p>\n

\u201cWe give injections in the mouth all day long, and these are very precise kinds of injections,\u201d Wood said. \u201cI think the learning curve for a dentist would be small.\u201d<\/p>\n

Dr. Bill Schaffner, a professor of preventive medicine and infectious disease at Vanderbilt University, said these proposals for expanding the vaccine workforce are promising. Flu vaccines, which are relatively low-risk and simple to administer, would be the perfect candidate to stock in dental and optometric fridges to start.<\/p>\n

But Schaffner doesn\u2019t believe dentists and optometrists will play a major role in the COVID immunization effort. It would take too long to pass legislation to expand the scope of practice for every professional who wants it in every state, he said. And since some COVID vaccines have specific shipping and subzero storing requirements, they will probably be distributed only to specially trained personnel at a small number of locations, he said.<\/p>\n

There\u2019s also the question of payment. It\u2019s hard \u2014 but not impossible \u2014 to make a profit administering vaccines, Schaffner said.<\/p>\n

Providers have to decide each season how many doses to buy, and any that go bad or remain in the fridge at the end of their shelf life equal monetary losses.<\/p>\n

\u201cUnless you\u2019re very assiduous about moving the vaccine from the fridge into arms, you\u2019re not going to make money,\u201d Schaffner said. \u201cPeople who do that can augment their income, but nobody is going to drive a Porsche because of vaccines.\u201d<\/p>\n

Jeff McCombs, an associate professor of health economics at the University of Southern California School of Pharmacy, agreed it might not make business sense for most dentists to start vaccinating. He said it would be hard to keep a well-stocked vaccine fridge with enough variety to meet patients\u2019 needs without wasting doses. Generally, adults who choose not to get vaccinated do so because they\u2019re uneducated about vaccines or afraid, he said, not because they can\u2019t access them.<\/p>\n

\u201cI don\u2019t think it\u2019s going to harm people,\u201d McCombs said. \u201cI just don\u2019t think they\u2019ll make any money at it.\u201d<\/p>\n

While the California Department of Public Health said the state\u2019s current vaccine infrastructure is sufficient for flu shots and routine immunizations, it is \u201ccarefully considering the need to include additional types of immunizers\u201d to get Californians vaccinated against COVID-19, according to a statement from the department.<\/p>\n

The California Optometric Association said it is in talks with Gov. Gavin Newsom\u2019s vaccine task force about how to get optometrists into the mix, and is exploring legislative options as well.<\/p>\n

\u201cWe can serve the dual role of assisting with vision needs and protecting from COVID,\u201d said David Ardaya, an optometrist in Whittier who chairs an association committee that is looking into the issue. \u201cOur whole hope is to assist our nation in regaining its health and in returning to a sense of normal.\u201d<\/p>\n

But three years after AB-443 was signed, the regulations implementing it have yet to be finalized.<\/p>\n

That didn\u2019t stop Frank Giardina, an optometrist in Nipomo, from going through a certification program anyway.<\/p>\n

The 20-hour course, which includes online lectures, hands-on lessons and an exam, is the same course pharmacists take when learning how to give all vaccines to people of all ages.<\/p>\n

Giardina pointed to the shingles, or herpes zoster, virus as an example of why optometrists are well suited to give vaccines. The virus can infect the eyes, and even though he\u2019s allowed to treat shingles, he can\u2019t give a vaccine to prevent it.<\/p>\n

For now, he\u2019s holding out hope he will get permission to administer vaccines, including for COVID-19. He envisions a world in which a patient comes in for contact lenses and he can offer them a flu or COVID vaccine while they\u2019re there.<\/p>\n

\u201cWe\u2019re another member of the health care team. It\u2019s a waste of manpower not to,\u201d Giardina said. \u201cIf you\u2019re trying to vaccinate all these people, especially in rural areas, you need whoever you can find.\u201d<\/p>\n

Subscribe<\/a> to KHN’s free Morning Briefing.<\/p>\n

KHN<\/a>\u00a0(Kaiser Health News) is a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

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