COVID-19

COVID-19 issues are rapidly and continually evolving. The following information is current as of the publication date listed.

Dear Colleagues,

PDHA has fielded many calls and emails regarding the administration of the COVID-19 vaccination.

We have consulted with PDHA legal counsel Jason G. Benion, Esq. According to Mr. Benion at this time, dental hygienists in Pennsylvania are not authorized to administer COVID-19 vaccines.

Under the federal Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID-19 (PREP Act), the U.S. Department of Health and Human Services (HHS) may declare those professionals who are authorized to administer COVID-19 vaccines. This declaration preempts any state law that prohibits a person from doing so. An authorized person also is immune from liability for claims resulting from administration of the vaccine.

HHS recently expanded the list of individuals authorized to administer COVID-19 vaccines to include certain health care professionals (for example, paramedics, dentists, and physician assistants), recently retired professionals, and students. However, HHS has not authorized dental hygienists to administer the vaccines.

ADHA has advocated that dental hygienists be authorized to administer COVID-19 vaccines and continues to work with federal agencies on this matter.

The PREP Act and HHS’ declaration also incorporate state laws that authorize individuals to administer COVID-19 vaccines. Some states have authorized dental hygienists, typically those with an anesthesia permit, to do so.

Pennsylvania, however, has not specifically authorized dental hygienists to administer COVID-19 vaccines, and vaccine administration is not part of the usual scope of a hygienist’s practice. Legislation recently introduced in the General Assembly would simply incorporate into Pennsylvania law HHS’ list of authorized persons, under which hygienists are not authorized to administer vaccines.

We will continue to monitor this situation for further developments.

Sincerely yours,

Carolynn B. Wahl, BSDH, PHDHP
PDHA Government Relations Chair

CDC 9/10/21 update: The CDC updated the “Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic”. This update streamlines guidance across various healthcare settings. For the current guidance, visit the source at:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

Key Points:

This guidance applies to all U.S. settings where healthcare is delivered, including home health.
CDC has updated select healthcare infection prevention and control (IPC) recommendations in response to COVID-19 vaccination, which are now summarized in this guidance.

Updates as of September 10, 2021

Updated source control recommendations to address limited situations for healthcare facilities in counties with low to moderate community transmission where select fully vaccinated individuals could choose not to wear source control. However, in general, the safest practice is for everyone in a healthcare setting to wear source control.
Updated quarantine recommendations for fully vaccinated patients who have had close contact with someone with SARS-CoV-2 infection to more closely align with recommendations for the community.
Clarified the recommended intervals for testing asymptomatic HCP with a higher-risk exposure and patients with close contact with someone with SARS-CoV-2 infection.
Added content from previously posted CDC guidance addressing:
Recommendations for fully vaccinated HCP, patients, and visitors
SARS-CoV-2 testing
Duration of Transmission-Based Precautions for patients with SARS-CoV-2 infection
Specialized healthcare settings (e.g., dental, dialysis, EMS)

CDC 9/10/21 update: Oral Health: CDC Updates COVID-19 Infection Prevention and Control Guidance. Visit the source at:

https://www.cdc.gov/oralhealth/infectioncontrol/statement-COVID.html

CDC has updated its infection prevention and control (IPC) guidance for healthcare settings. These updates do not contain substantial changes in recommended practices but, rather, have primarily been made to streamline and consolidate existing healthcare IPC guidance so that it is applicable to multiple settings and scenarios, making it easier to for healthcare providers to find relevant guidance. As a part of this update, multiple setting-specific guidance documents, such as those for dental offices, assisted living facilities, emergency medical services, and dialysis clinics, have been streamlined and combined into the main IPC guidance for healthcare settings.

The updated Infection Control Guidance for Healthcare Professionals about Coronavirus (COVID-19) is applicable to all U.S. settings where healthcare is delivered, including dental settings. Dental healthcare personnel (DHCP) should refer to this guidance, which includes a section specific to dental settings, for infection control considerations during the COVID-19 pandemic. As of September 10, 2021, the Guidelines for Dental Settings will display a web banner noting that the page will no longer be updated, and webpage visitors will be redirected to the Infection Control Guidance for Healthcare Professionals about Coronavirus (COVID-19) page.

Updates to the interim IPC recommendations include:

Clarified source control recommendations for healthcare personnel, patients, and visitors, to better align with community guidance, including limited circumstances where fully vaccinated individuals could choose not to wear source control.
Updated quarantine recommendations for fully vaccinated patients with exposure to SARS-CoV-2 to be consistent with community guidance.

Healthcare personnel continue to be on the front line of the nation’s fight against COVID-19. By providing critical care to those who are or might be infected with the virus that causes COVID-19, some healthcare personnel are at increased risk of infection from COVID-19. CDC recommends healthcare personnel get vaccinated against COVID-19 as soon as possible.

DHCP should regularly consult their state dental boards and state or local health departments for current information and recommendations and requirements specific to their jurisdictions, which might change based on level of community transmission in the county where their healthcare facility is located. As a reminder, DHCP are licensed by their state regulatory body and should practice according to their state dental practice acts or other relevant regulations.

CDC continues to update public health guidance documents based on the best available science. You can find the most up-to-date information about infection prevention and control practices on CDC’s COVID-19 page.

PENNSYLVANIA DEPARTMENT OF HEALTH – HEALTH ALERT NETWORK (PA-HAN)

PA-HAN 9/16/21 “UPDATE: Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19”. Read the document at:

https://www.health.pa.gov/topics/Documents/HAN/2021-595-9-16-UPD-%20Return%20to%20Work.pdf

Minor updates were made to the CDC guidance for Return-to-Work Criteria for healthcare personnel (HCP) on September 10, 2021. These updates include:

• The definition of immunocompromised has changed based on evolving science, and now refers to the CDC guidance.

• When using a symptom-based strategy to determine when HCP with severe to critical illness or who are moderately to severely immunocompromised can return to work, the language has changed to rely more on clinical judgement. In brief, HCP in this category can return to work when at least 10 days and up to 20 days have passed since symptoms first appeared

PA-HAN 9/16/21 “UPDATE: Work Restrictions for Healthcare Personnel with

Exposure to COVID-19”. Read the document at:

https://www.health.pa.gov/topics/Documents/HAN/2021-596-9-16-UPD-Work%20Restrict.pdf

There are minor changes to the guidance on how to evaluate and respond to exposure of healthcare personnel (HCP) to COVID-19. This update adds the following clarifications:

• Asymptomatic HCP with a higher-risk exposure, regardless of vaccination status, should have a series of two viral tests for SARS-CoV-2 infection. In these situations, testing is recommended immediately (but not earlier than 2 days after the exposure if the date of a discrete exposure is known) and 5–7 days after exposure.

• For vaccinated HCP who are not excluded from work following a higher-risk exposure, source control should be maintained at all times while in the healthcare facility for 14 days following exposure.

• Changes were made to Section 5 outlining when to consider quarantine for fully vaccinated or recently infected (<90 days prior) HCP. Specific changes include:

o Removing the recommendation for those who are exposed to a novel variant; and

o Adding a recommendation to consider quarantine for these persons in the event of ongoing transmission within a facility that is not controlled with initial interventions.

PENNSYLVANIA STATE BOARD OF DENTISTRY (SBOD) UPDATES

For the latest information from the SBOD, visit:

https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Dentistry/Pages/default.aspx

SBOD 06/11/2021 update: With the Governor’s signing of HB 854 (now Act 21 of 2021), licensing waivers will remain active until September 30, 2021, unless ended sooner. The SBOD will provide additional updates as more information becomes available. Link to the licensing waivers:

https://www.dos.pa.gov/Pages/COVID-19-Waivers.aspx

COALITION FOR MODERNIZING DENTAL LICENSURE (CMDL)

PDHA has become a part of the Coalition for Modernizing Dental Licensure.

CMDL has two strategic goals:

Achieve adoption of valid and reliable examinations for dental licensure (including dental and dental hygiene) that do not involve the use of single encounter, procedure-based examinations on patients.
Achieve portability of dental licensure (including dental and dental hygiene) among all licensing jurisdictions in the United States for the benefit of the public and the profession.

To learn more about the Coalition, visit their website at:

https://www.dentallicensure.org/en/who-we-are

COVID-19

Just a reminder that the PA DOH COVID-19 Vaccine Provider Map is up and running and will continuously be updated. For current vaccine provider information please visit:

https://www.health.pa.gov/topics/disease/coronavirus/Pages/Vaccine.aspx#map

We continue to follow the Pennsylvania Department of Health guidance issued on June 3, 2020. You can visit the DOH’s webpage here to read the “Interim Guidance on COVID-19 for Dental Health Care Personnel in Pennsylvania”:

https://www.health.pa.gov/topics/disease/coronavirus/Pages/Guidance/Dental-Personnel-COVID-19.aspx

The Centers for Disease Control and Prevention “Interim Infection Prevention and Control Guidance for Dental Settings During the Coronavirus Disease 2019 (COVID-19) Pandemic” current guidance:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

ADHA COVID-19 resource center: This robust resource center is updated regularly. Please check back often at:

https://www.adha.org/covid19

June 11, 2021
Pennsylvania State Board of Dentistry update: With the Governor’s signing of HB 854 (now Act 21 of 2021), licensing waivers will remain active until September 30, 2021, unless ended sooner. The SBOD will provide additional updates as more information becomes available. Link to the licensing waivers:
https://www.dos.pa.gov/Pages/COVID-19-Waivers.aspx