We have entered a new phase of the COVID-19 pandemic. A phase that is not only critical but that also offers great hope. It encompasses the monumental task of vaccinating hundreds of millions of Americans with the newly available COVID-19 vaccines. And, to do it as rapidly and safely as possible in order to get this crisis under control. To accomplish this enormous task, we must produce enough vaccine to cover the population. Equally important, we need to ensure the vaccine is readily available to everyone who wants it. This article explores the role that dentists can (and should) play in COVID-19 vaccine distribution and administration.
States are just now finalizing plans for vaccine distribution. The Centers for Disease Control and Prevention’s Advisory Committee on Immunizations recommends that dental professionals be included in the first group of health care personnel to receive the vaccine.[1]. This same group of health care professionals stands ready to serve as an essential part of vaccine distribution plans. However, this important resource is at risk of being overlooked.
The role of dentists in vaccine administration
Dentists administering vaccines during public health emergencies is not a groundbreaking idea. It’s common sense. In fact, it’s been done in the past.
Dentists in states like Massachusetts and New York were deputized as vaccinators during the H1N1 swine flu pandemic in 2009-10 [2]. Other states like Illinois [3] and Minnesota [4] currently allow dentists to administer flu vaccines. Oregon [5] goes even further, by allowing dentists to prescribe and administer vaccinations including the annual flu shot, the human papillomavirus vaccine, and more.
Dentists and dental hygienists have foundational training and capabilities to administer these vaccines. They already routinely give injections in the mouth, a procedure that is much more precise than injecting a person’s arm.
Additionally, dental offices typically have the equipment, storage, and medical office space that can easily be adjusted to house and administer vaccines in a condensed time frame. This is especially true for dentists and dental practices in public health settings like Federally Qualified Health Centers (FCHQs).
Dentists have access to a wide range of patients
Dentists provide something else critical to distributing this vaccine as comprehensively and equitably as possible.
That is access to a wide range of patients. On a yearly basis, more than 18 million people visit the dentist even though they haven’t visited a primary care physician or another medical professional.
Many dental professionals, especially those operating in community health settings like Federally Qualified Health Centers, are well-positioned to serve as a trusted public health access point to traditionally underserved populations.
These FQHCs operate more than 12,000 locations across the nation and are intentionally located to be accessible to communities of color, which have been among the most impacted by COVID-19.
Similarly, dentists can be crucial in rural communities, another area severely impacted by the pandemic. And, where the number of health care professionals is often more limited compared to densely populated urban areas.
Some states – even those beyond rural America – are facing difficulties in finding enough health care workers to administer vaccines. MaineHealth, Maine’s largest health care system, for instance, is facing a significant challenge [6] in identifying a sufficient number of doctors and nurses to vaccinate Maine residents. As a result, MaineHealth has been recruiting retired doctors and nurses for vaccination for weeks.
Dentists possess a crucial factor in the vaccination process: Trust
Beyond the necessary expertise and access to a greater number of patients, dentists possess what may be viewed as the most critical factor in the vaccination process: Trust.
Related Content: Fear of COVID-19 Keeps Patients From Seeking Medical Care
Dentists often have a lifetime relationship with their patients, seeing their patients from their childhood years throughout their adulthood. Visiting the same health professional, staff, and office over many years establishes a level of comfort and trust which is important when receiving a vaccine.
According to a recent American Dental Association survey [7], when asked if they would get any vaccine from a dentist, 60 percent of people said yes. More specifically, 59 percent said they WOULD get the COVID-19 vaccine from a dentist.
The movement to empower dentists to administer the COVID-19 vaccine
Thankfully, there has been some positive movement to empower dentists to administer the COVID-19 vaccines when they become more widely available.
In October, the federal Centers for Medicare and Medicaid Services recommended that states expand their list of vaccine providers. [7] Oregon’s law permitting dentists to administer vaccines more broadly was passed in 2019.
Dentists in that state are currently undergoing specialized training. So far, more than 200 dentists and dental students have completed the training courses. Sixty others expected to finish by the end of this month. Once they 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.
The Executive Director of the Oregon Dental Association says dentists in Oregon could be administering the COVID-19 vaccine as soon as February or March 2021.[8] States like Arkansas and Massachusetts have already moved to allow dentists to administer COVID-19 vaccines.
More than half of states are considering using dentists to vaccinate
More than half of states are similarly considering allowing dentists to administer the vaccine. [9] That consideration shouldn’t take long. Allowing dentists to perform a service that they are able and qualified to perform could increase the number of health care professionals administering the vaccine by the tens of thousands. This would expedite getting shots into arms. This is exactly what public health experts say will save lives and ultimately bring the pandemic to an end.
In California, the state’s dental association has been lobbying lawmakers to pass a law that allows dentists to administer the vaccine. The association estimates that vaccinating every resident in the state would require 200,000 shots a day for one year. [10]
Adding dentists to the list of those who can administer the COVID-19 vaccine could mean adding 36,000 immunizers to the workforce. This could significantly speed up the vaccination process in places where COVID-19 cases have remained particularly high throughout the pandemic.
Some states have failed to include dental professionals in the distribution plans that list those authorized to administer the COVID-19 vaccine. Whether by oversight or intentional exclusions, we urge states to reconsider this.
We must recognize that to beat this virus we need all hands on deck. Excluding these qualified providers may result in prolonging the crisis we are in.
The bottom line
For too long, oral health has been treated as an afterthought to overall health care. But the fact is that oral health is overall health.
Poor oral health has a direct link to higher risks of chronic illnesses and mental health diseases. Further, there is even evidence that preventive oral health care mitigates some of the greatest risks associated with the treatment of COVID-19. [11] It’s why dentists took extraordinary steps to ensure that they could return to offering safe, preventive oral health treatment during this pandemic.[12]
Now, they are poised to play another essential role — distributing the vaccine to those who need it.
Let’s just hope public health leaders will let them.
References:
- Garvin J. ADA urges CDC to include dentists in COVID-19 vaccine plan, 2020 Nov. 20, ADA News. https://www.nbcsandiego.com/news/local/your-vaccine-appointment-could-be-set-at-dentist-or-eye-doctors-office/2472635/. Accessed 12/22/20
- Association of state and territorial health officials. ASTHO Legal Preparedness Series. Scope of Practice Toolkit, 2012 https://www.astho.org/uploadedFiles/Programs/Preparedness/Public_Health_Emergency_Law/Scope_of_Practice_Toolkit/03-SOP%20H1N1%20State%20SOP%20FS%203-12%20Final.pdf Accessed 12/22/20
- University of Illinois College of Dentistry CE Course: Influenza Vaccination 12/1/2017. https://dentistry.uic.edu/calendar/ce-course-influenza-vaccine. Accessed 12/22/20
- Minnesota Department of Human Services, Provider Manual, Immunizations, and Vaccinations, revised: April 6, 2020 https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_136660 Accessed 12/22/20
- OHSU News, Get the flu shot, your teeth cleaned in one visit: F. White, 5/7/2019 https://news.ohsu.edu/2019/05/07/get-the-flu-shot-your-teeth-cleaned-in-one-visit Accessed 12/22/20
- Bangor Daily News, Maine dentists offer help to administer COVID-19 vaccines, E. Pendharkar, 12/16/2020 https://bangordailynews.com/2020/12/16/news/maine-dentists-offer-help-to-administer-covid-19-vaccines/ Accessed 12/22/20
- NBC San Diego News, Your Vaccine Appointment Could Be Set at Dentist Or Eye Doctor’s Office, 12/16/2020 https://www.nbcsandiego.com/news/local/your-vaccine-appointment-could-be-set-at-dentist-or-eye-doctors-office/2472635/ Accessed 12/22/20
- CMS, Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration, and Cost Sharing under Medicaid, the Children’s Health Insurance Program, and Basic Health Program Toolkit, Updated 12/17/20 https://www.medicaid.gov/state-resource-center/downloads/covid-19-vaccine-toolkit.pdf Accessed 12/22/20
- ABC News KATU 2, Portland, Oregon, Dentists will be able administer COVID-19 vaccine in Oregon, w. Ogle, 12/17/2020 https://katu.com/news/local/dentists-will-be-able-administer-covid-19-vaccine-in-orego Accessed 12/22/20
- Brian Z. Dentists’ Role in Vaccination: An Opportunity for Public Health Impact. NC Oral Health Collaborative, 2020 Aug 25. https://oralhealthnc.org/dentists-role-in-vaccination-an-opportunity-for-public-health-impact/ Accessed 12/22/20
- NBC San Diego News, Your Vaccine Appointment Could Be Set at Dentist Or Eye Doctor’s Office, 12/16/2020 https://www.nbcsandiego.com/news/local/your-vaccine-appointment-could-be-set-at-dentist-or-eye-doctors-office/2472635/ Accessed 12/22/20
- DentaQuest Partnership for Oral Health Advancement, Best Practices Issued to Ensure Re-opening for Dentists and Patients, 6/22/2020 https://www.dentaquestpartnership.org/about/news/best-practices-issued-ensure-safe-re-opening-dentists-and-patients?utm_source=pr&utm_medium=blog&utm_campaign=covid&utm_content=vaccinedistroAccessed 12/22/20
Myechia Minter-Jordan, M.D.
Website:
https://www.dentaquestpartnership.org/dentaquest-partnership-for-oral-health-advancement
Dr. Myechia Minter-Jordan graduated from Brown University School of Medicine and the Johns Hopkins University Carey School of Business. She also received honorary doctorates from Northeastern University and Newbury College.
She is President and CEO for the DentaQuest Partnership for Oral Health Advancement and Catalyst Institute. In this role, she oversees the DentaQuest Partnership for Oral Health Advancement and Impact Group, leading research and grantmaking activities focused on improving oral health, integrating oral health and overall health through medical/dental collaborations, moving toward a value-based payment model, and guiding a growing research and data portfolio.
Myechia joined DentaQuest in 2019 after twelve years at the Roxbury, Mass.-based Dimock Center. Considered a national model for comprehensive health and human services, Dimock focuses on the integration of clinical and behavioral health and is the second largest health center in the Boston area. As CEO, Myechia formed partnerships with world-class institutions, including Harvard Medical School, Beth Israel Deaconess Medical Center, and Partners HealthCare to advance person-centered care.
Before her position as CEO, Myechia served as Chief Medical Officer at Dimock and successfully led transformative efforts including the switch to an electronic medical record system, establishing an Institutional Review Board, and earning a $4.9 million federal grant to become a designated primary medical home. Prior to Dimock, Myechia worked for Johns Hopkins Medicine as an attending physician and instructor of medicine.
Myechia serves on several boards and committees that include the Yawkey Foundation, The Boston Foundation, Harvard School of Dental Medicine, Harvard Pilgrim Health Care and the Isabella Stewart Gardner Museum.
In the past, she has served on several boards and committees that include appointed positions within the Commonwealth of Massachusetts and the City of Boston including MA Health Planning Council Advisory Committee, the Boston Public Health Commission, and RIZE Massachusetts where she focused on combating the opioid epidemic.
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