Should dentists offer vaccines? What is the dentist’s ethical obligation if patients and/or staff members refuse vaccination? Do dentists have an ethical/professional obligation to be vaccinated themselves?
   
These are the questions and topics the ADA Council on Ethics, Bylaws and Judicial Affairs explored in its white paper published April 27 addressing the ethical issues raised by vaccinations that dentists may face.
   
The white paper, “Ethics of Vaccination,” does not focus on one vaccine in particular but on the process of vaccination more generally.
   
“The vaccination white paper serves as a guide to educate our members on an important issue that is the mainstay of our current generation,” said Guenter J. Jonke, D.M.D., council member and chair of the its ethics subcommittee. “It is a great way to share the council’s perspective to our membership and offer ethical consideration of this issue.”
   
The resource arrives as COVID-19 continues to spread worldwide, with at least three COVID-19 vaccines approved for emergency use in the U.S. under a federal emergency directive; dentists and dental students are currently authorized to administer COVID-19 vaccines.
    
“The dental profession has been a leader and an example in the safe delivery of care with a minimal risk of disease transmission in the dental operatory,” said council chair Robert Wilson, D.D.S. “The profession is continuously refining and enhancing safety protocols. The COVID -19 vaccine is a visible example of how immunization has the potential to further mitigate risks to providers, support staff and patients while care is provided in the dental office. This applies to other vaccines as well.”

A range of preventable communicable diseases have reemerged in recent years including measles, mumps, pertussis and human papillomavirus.
   
“With the number of infectious diseases rising rapidly or continuing to spread … dentists face a number of considerations that have ethical dimensions,” according to the white paper.
   
“The council has been discussing vaccines for several years now,” said Dr. Wilson. “The measles outbreaks that occurred a few years ago provided further impetus to begin the development of a white paper, and the COVID-19 pandemic has resulted in unprecedented attention to vaccinations in the dental office.”
   
The white paper examined the ethical questions dentists may face through the lens of the ADA Principles of Ethics & Code of Professional Conduct. It applied the five principles of the Code — autonomy, nonmaleficience, beneficence, justice and veracity — to provide dentists guidance on the ethical and professional obligations regarding vaccinations.
   
The paper also lists recommendations and a checklist of questions to ask. These include:
• Dentists can give vaccines when it is permissible under their state act or other government order, and if they have received the training to do so.
• Dentists need to give thought to how to deal with patients who cannot be vaccinated or do not choose to be vaccinated.
• Dentists cannot use vaccination status as a marketing tool.
• Dentists cannot abandon patients or breach their privacy/confidentiality regardless of vaccination status.

“As an important resource, the white paper can help dentists decide whether to offer vaccinations in their respective offices,” Dr. Jonke added. “As in our Principles of Ethics & Code of Professional Conduct, we have the obligation of keeping our knowledge and skills current. Every ADA member should read this report for themselves and their staff, recognizing that their primary goal is the benefit of the patient.”
   
To read the white paper, visit ADA.org.