It makes sense that healthcare workers giving COVID-19 vaccine shots should themselves be vaccinated.
In California’s San Diego County, a health department spokesperson assured MedPage Today in an email, “All vaccinators are required to have received the vaccination prior to administering vaccines.”
But the reality on the ground appears quite different.
Sherry Franklin, MD, former president of the county medical society and a retired pediatric endocrinologist, said no one ever asked her if she had received her shots when she applied to be a vaccinator for the county health department. When she showed up for her first shift on Jan. 24, no one offered it to her then either. Luckily, she’d managed to get her first shot through her connections a week earlier, but had no appointment for her second shot.
“What if I have [the infection] and give it to people sitting right across from me? It’s great that we both have masks on, but the recommendation is to be six feet apart when in public and when outside. We’re inside and I’m one foot away from them,” said Franklin, who now does post-utilization reviews for United Healthcare. “I can have this and kill someone.”
Ironically, she said, the volunteer application form asks about vaccinations against measles, mumps, rubella, smallpox, and influenza. But not against COVID-19.
Another retired physician vaccinator noted that at drive-through COVID-19 clinic sites, passengers may wait for hours in their vehicles without wearing masks, only to don masks when it’s their turn and they roll down their windows to speak, fill out forms, and get the shot. All that air comes out the window as the driver breathes out — in the direct line of the vaccinator, this physician said.
The University of California San Diego health system, which runs a large vaccination “Super Station” near the Petco Park baseball stadium, doesn’t require vaccinators to be vaccinated before administering shots.
Not only is the vaccination center outdoors, “moreover, all vaccinators and vaccine recipients are masked,” Scott LaFee, UCSD spokesman, wrote in an email after consulting with physician vaccine experts. “And safe distancing is practiced as much as possible, with minimal time spent in close proximity to patients,” LaFee wrote. “Persons getting vaccinated should not be symptomatic; those who have had an exposure are asked to wait until completing quarantine before vaccination.”
He noted that there’s been no documented evidence of transmission stemming from the site and that physician workers “consider the concerns described below to be a non-issue,” he wrote.
California’s Department of Public Health is vague on the subject.
Its website advises: “To prevent hospitalizations and deaths, to more effectively and expeditiously administer vaccines, and to maintain hospital services to all Californians, especially in the most impacted communities, California will prioritize vaccinating health care personnel, including vaccinators, and all persons 65 years of age or older.”
“Prioritize” is not the same as requiring it, however.
George Rutherford, MD, director of prevention and public health group at the University of California San Francisco and former head of the San Francisco County Health Department, said vaccinating vaccinators is important, but the priority right now is to get as many people in the community vaccinated as possible.
“Let’s not hold things up for four to five weeks getting everyone vaccinated,” Rutherford wrote in an email, referring to the waiting time between the two doses plus the waiting period for full immunization. “God knows, we were intubating and doing invasive procedures without vaccines as recently as December.”
Around the country, vaccine clinic requirements vary as well, with many not requiring vaccinators to be fully or even partially vaccinated when they start inoculating.
At Rowan School of Osteopathic Medicine in Stratford, New Jersey, family medicine chair Joshua Coren, DO, says all vaccinators are offered the vaccine for themselves when they show up to administer the shots to between 300 and 400 people each day. It’s administered to them during a lull, or at the end of their shift. Coren also is the medical director for Rowan’s COVID vaccine clinic.
Yes, there’s a risk that they may be exposed to the infection before they have developed an immune response, which would reach maximum about a month later. But it’s extremely small, he said, especially given their exposure to the patient for roughly one minute or less.
“You have to look at benefits and risks in life, and the benefits from this vaccine are enormous,” he said. Besides, all vaccinators, runners, and data entry personnel working in the clinic are distanced from each other and are wearing PPE, including face shields and N95 masks, he said.
Coren conceded that knowledge is evolving on best practices, and that as of now, “there’s no script on this. Everybody is going to do it differently throughout the U.S. and is learning.”
MedPage Today reporter Ryan Basen contributed to this story.
Source: MedicalNewsToday.com
