University instructors began fielding the angry calls in January soon after pictures of students giving COVID-19 vaccines were in the news and on social media.
Even the Spokane Regional Health District heard pushback. The outcry? Gloves weren’t being worn by the depicted vaccinators – Washington State University nursing and pharmacy students – providing the shots at recent community clinics.
However, WSU and health district leaders had a government-backed answer: Gloves aren’t required most times when giving vaccinations – and specifically for COVID-19 vaccines – under local, state, U.S. and World Health Organization guidelines. Along with the state Department of Health, the agencies list several reasons why, including that gloves in this scenario can discourage proper hand hygiene and increase the likelihood of spreading germs.
“The link that DOH has talks about how they find when you wear gloves when it’s unnecessary, it reduces the amount of hand hygiene statistically,” said Kayla Myers, a SRHD specialist leading its COVID-19 vaccination task force.
“It makes people feel like they’re more protected than they are. Sometimes, it’s not done properly, such as changing gloves between patients, and then every time you change gloves, you’re supposed to use rubbing alcohol or wash with soap and water. You’re supposed to wash your hands before putting a new pair on.
“It’s this whole process where the gloves are mainly meant for when you’re going to be around mucous membranes or have more of an amount of blood than you would get with a needle stick or have skin that’s not intact.”
There’s also concern about personal protective equipment shortages and giving hospital staff the priority for medical gloves as they’re around more blood, mucous membranes and COVID-19 patients, said Kay Olson, a WSU College of Nursing senior instructor. In many situations, nursing students do wear gloves, but the college is following guidance for administering vaccines.
“Times are different right now – there is a shortage of PPE still – so we’re really leaning on the Department of Health and the CDC to guide us, and they say gloves are not recommended for most vaccinations and are not required for giving the COVID vaccine,” Olson said.
“Generally, when we wear our PPE, it’s to protect from any blood-borne pathogens, but with vaccinations, the risk is low. We do get people who bleed, but it’s not a lot of them, and we have steps in place.”
The health district, the state health department, the Centers for Disease Control and Prevention and WHO list how gloves used improperly can be less sterile, cause a false sense of safety and result in less hand hygiene – and increase the likelihood of spreading germs.
The state refers to the Association for Professionals in Infection Control and Epidemiology, saying, “Gloves are not a substitute for hand washing. … Germs collect on the gloves when a person wearing them starts touching surfaces.”
Medical gloves are required for intranasal or oral vaccinations. If gloves are used, “They should be changed between patients along with performing proper hand hygiene … If nitrile gloves are a limited resource, prioritize and consider appropriate uses,” state guidelines say.
Olson said students are being supervised by nurse professionals at the clinics, and the vaccinators use an alcohol-based hand sanitizer between each patient. Masks are worn by everyone. At arrival, people are screened to ensure they don’t have COVID-19 symptoms. The vaccine shot is brief, with a vaccinator typically to the side of a patient to administer a shot into an arm.
Each station is periodically sanitized, Olson said. At some COVID-19 vaccine sites, Olson is aware nurses and volunteers are wearing gloves, “and that’s phenomenal,” she said. “We’re doing some at some of the smaller locations, and the resources aren’t as plentiful.”
WSU instructors also are providing shots at those smaller clinics using government-sent “ancillary supply kits” for 100 doses. These kits contain needles, syringes, alcohol prep pads and a few surgical masks, but they don’t come with medical gloves, both Myers and Olson said.
Olson said WSU students are trained to assess a patient’s information before giving the shots, and if a person lists they’re taking blood thinners or writes, “I’m a bleeder,” then the students know to put on gloves. “Or if the student has any skin issues or open wounds, or the patient does, we glove up.”
WSU college leaders were surprised about the glove-related calls, including from nurses. They said in answering them and citing current health guidance, people were often positive and said they didn’t know about the current recommendations.
“Oh my gosh, yes, it was amazing how much people were so angry that we weren’t wearing gloves,” said Wendy Williams-Gilbert, director of the Bachelor of Science in nursing program. She’s fielded many of the calls. “I’ve been doing flu shot clinics for 20 years, and we’ve never worn gloves for immunization clinics.”
“At first, I thought people would just be so happy our students were out there volunteering literally hundreds of hours to the community – all the health sciences are – we’ve really been out there in full force. We were really shocked at the pushback.
“It was a little disheartening, too. They were sort of focused on thinking we’d send students out without proper PPE, so we spent a lot of time referring people back to the CDC’s website and the Spokane Regional Health District’s website.”
The students are excited to be part of the solution, Williams-Gilbert said, and they’ve had positive feedback about their vaccination techniques. She thinks what’s key in training future health workers to assess care situations.
“The most important thing for our nursing students is we’re teaching them to access the situation and to advocate for situations when certain PPE is important, and then to know when they don’t have to use different types of PPE.
“That’s part of the beauty of nursing, right? We have this ability to assess the situation to know what we need and act on it. I think that’s what makes great nurses.”
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