Vaccination Considerations in Dentistry
Vaccines with proven short–term efficacy against COVID-19 are now available.
Vaccines with proven short–term efficacy against COVID-19 are now available. This is good news. At the same time, significant barriers exist to achieving the herd immunity needed to control the pandemic. Among these are patient-related issues that must be overcome so an adequate number of individuals receive the “jab,” as our British cousins say. At this point, the ramifications of immunization in dentistry remain to be seen.
One of the largest hurdles is what the World Health Organization calls vaccine hesitancy, defined as a “delay in acceptance or refusal of vaccines.” Resistance has been an issue since the smallpox vaccine was introduced in 1796. Early doubts sprang from concerns over interfering with nature. Resistance today is more multifaceted and includes distrust of “Big Pharma” and our leaders, as well as safety concerns over the vaccines’ accelerated development. Given these factors, it is difficult to separate the wheat from the chaff due to the sophistication of the misinformation that is circulating.
SIGNIFICANT BARRIERS EXIST TO ACHIEVING THE HERD IMMUNITY NEEDED TO CONTROL THE PANDEMIC
Regardless of your views on vaccination, and the COVID-19 vaccine in particular, there is evidence of the negative consequences of vaccination resistance — which, for example, appears responsible for the recent measles outbreaks. Much of the concern over that vaccine was generated by a 1998 article in Lancet that linked the measles, mumps, rubella vaccine to autism spectrum disorders.1 That article was later withdrawn due its lack of scientific validity, and while further research found no link between the vaccine and autism,2 the damage was done.
With COVID-19 vaccines now available, a key question in oral healthcare is what can be done about staff members and patients who refuse to be vaccinated. The U.S. Equal Employment Opportunity Commission has said employers can order staff to take the vaccine (exceptions include individuals with medical precautions or certain religious beliefs). But practices that require COVID-19 vaccination must consider the possible negative effects. Will the resulting ill will be offset by the protection provided to other team members and patients? As for patients, it can be assumed that requiring patients to be vaccinated is not realistic. Rather, most offices will address this by questioning patents about their vaccination status, as well as medical history, risk factors and symptoms. Rapid in-office testing may also become part of practice protocols, but until these tests are widely available it is safest to treat all patients as though they could transmit the virus.
Regardless of your approach to vaccination, COVID-19 will continue to shape our professional and personal lives for the foreseeable future. Although immunization will surely help curb transmission, ultimately, prudent professionals will continue to exercise due diligence when providing care.
Thomas G. Wilson Jr., DDS
Editor in Chief
- Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351:637–641.
- Madsen KM, Hviid A, Vestergaard M, et al. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002;347:1477–1482.
From Decisions in Dentistry. February 2021;7(2):6.