Answer:

The U.S. Equal Employment Opportunity Commission issued guidance (section K) in December indicating that employers may encourage or possibly require COVID-19 vaccinations, but policies must comply with the Americans with Disabilities Act and Title VII of the Civil Rights Act of 1964.

If a practice owner chooses to mandate COVID-19 vaccines for employees, exceptions must be made for those who cannot be vaccinated due to a disability, medical complications, pregnancy or sincerely held religious beliefs. Also, some states may further limit the ability of practice owners to mandate vaccination.

Mandating vaccination may lead to difficult discussions or legal implications. A better approach may be to educate and encourage staff members to receive the vaccine.

Regardless of the approach, all vaccination programs should be implemented consistently throughout the practice, and discrimination of any kind should not be allowed. AAOMS recommends documenting the office policy endorsing vaccination and any individual employee declinations in the employee’s file. OMSs are encouraged to discuss any new policies with their practice attorney prior to implementation.

Answer:

No. Even after all staff have been vaccinated, practices must continue to follow current workplace safety standards, including patient screening, social distancing, adequate PPE and disinfection protocols. Resumption of standard precautions for dental procedures will be based on many factors, including local, regional and national spread of disease, achievement of herd immunity, individual dental healthcare worker risk of infection as well as CDC, OSHA, local, state and federal guidance.

Answer:

Per the CDC, “experts do not yet know what percentage of people would need to get vaccinated to achieve herd immunity to COVID-19. Herd immunity means that enough people in a community are protected from getting a disease because they’ve already had the disease or they’ve been vaccinated. Herd immunity makes it hard for the disease to spread from person to person, and it even protects those who cannot be vaccinated, like newborns. The percentage of people who need to have protection in order to achieve herd immunity varies by disease. CDC and other experts are studying herd immunity and will provide more information as it is available.”

Answer:

The CDC advises patients to wait at least 14 days before getting any other vaccine, including a flu or shingles vaccine, if they receive their COVID-19 vaccine first. If a patient gets another vaccine first, he or she should wait at least 14 days before getting the COVID-19 vaccine.

If a COVID-19 vaccine is inadvertently given within 14 days of another vaccine, the COVID-19 vaccine series does not need to be restarted. The series should still be completed on schedule. When more data are available on the safety and effectiveness of COVID-19 vaccines administered simultaneously with other vaccines, the CDC may update this recommendation.

Answer:

Per the CDC, “data from clinical trials indicate that mRNA COVID-19 vaccines can safely be given to persons with evidence of a prior SARS-CoV-2 infection. Vaccination should be offered to persons regardless of history of prior symptomatic or asymptomatic SARS-CoV-2 infection. Viral testing to assess for acute SARS-CoV-2 infection or serologic testing to assess for prior infection for the purposes of vaccine decision-making is not recommended.

“Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. This recommendation applies to persons who develop SARS-CoV-2 infection before receiving any vaccine doses as well as those who develop SARS-CoV-2 infection after the first dose but before receipt of the second dose.

“While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of SARS-CoV-2 reinfection is low in the months after initial infection but may increase with time due to waning immunity. Thus, while vaccine supply remains limited, persons with recent documented acute SARS-CoV-2 infection may choose to temporarily delay vaccination, if desired, recognizing that the risk of reinfection, and therefore the need for vaccination, may increase with time following initial infection.

“Currently, there are no data on the safety and efficacy of mRNA COVID-19 vaccines in persons who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. Based on the estimated half-life of such therapies as well as evidence suggesting that reinfection is uncommon in the 90 days after initial infection, vaccination should be deferred for at least 90 days, as a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses. This recommendation applies to persons who receive passive antibody therapy before receiving any vaccine doses as well as those who receive passive antibody therapy after the first dose but before the second dose, in which case the second dose should be deferred for at least 90 days following receipt of the antibody therapy.

“For vaccinated persons who subsequently develop COVID-19, prior receipt of an mRNA COVID-19 vaccine should not affect treatment decisions (including use of monoclonal antibodies, convalescent plasma, antiviral treatment, or corticosteroid administration) or timing of such treatments.”

Answer:

Per the CDC, “vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. This recommendation applies to persons who develop SARS-CoV-2 infection before receiving any vaccine doses as well as those who develop SARS-CoV-2 infection after the first dose but before receipt of the second dose.

“The second dose should be administered as close to the recommended interval as possible. However, if it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after the first dose. There are currently limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window. If the second dose is administered beyond these intervals, there is no need to restart the series.”

Answer:

If you had a previous severe allergic reaction (anaphylaxis, treatment with epinephrine or hospitalization) to any ingredient in the mRNA COVID-19 vaccines, the CDC states you should not get either of the currently available mRNA COVID-19 vaccines. If you had a severe allergic reaction after getting the first dose of an mRNA COVID-19 vaccine, CDC recommends you should not get the second dose.

If you had a previous non-severe immediate allergic reaction (hives, swelling or respiratory distress within four hours of getting vaccinated) to any ingredient in the mRNA COVID-19 vaccines, the CDC recommends you should not get either of the currently available mRNA COVID-19 vaccines.

If you have had an immediate allergic reaction – even if it was not severe – to a vaccine or injectable therapy for another disease, ask your doctor if you should get a COVID-19 vaccine. Your doctor will help you decide if it is safe for you to get vaccinated.

If you had an immediate allergic reaction after getting the first dose of an mRNA COVID-19 vaccine, you should not get the second dose. Your doctor may refer you to a specialist in allergies and immunology to provide more care or advice.

Answer:

The answer is uncertain, as the vaccine studies performed were not designed to address this question. A reasonable assumption can be made from the data available. However, the conclusion must be considered within the context that approximately 8 percent of Moderna and 2 percent of Pfizer-BioNTech study participants received only one dose and very few dropped out due to adverse effects.

The Moderna vaccination study showed that participants who received the vaccine had an 80 percent lower rate of COVID-19 infection than their placebo counterparts. However, the study states, “the small, non-random sample and short median follow-up time limit the interpretation of these results. There appears to be some protection against COVID-19 disease following one dose; however, these data do not provide sufficient information about longer term protection beyond 28 days after a single dose.”

The Pfizer-BioNTech vaccination study showed that after approximately 14 days, study participants who received only one dose had an 82 percent lower rate of COVID-19 infection than their placebo counterparts. However, as with the Moderna study, very few participants received a single dose. It is supported by the evidence and explained by the basics of immunology that a single dose of these vaccines will render some level of immunity to recipients and level of immunity is likely to vary from person to person.