Doctors worry kids won’t get vaccinations

Without medical assistants available to administer injections, some Las Vegas pediatricians are worried children won't receive vaccinations and immunizations in a timely manner -- possibly resulting in an epidemic.

Pediatrician Kenneth Misch said he's in a "state of panic" over the potential consequences of an advisory from the Nevada State Board of Medical Examiners Wednesday, which said medical assistants were officially prohibited from administering injections.

Pediatricians are worried the system could become overwhelmed, especially when supplies of swine flu vaccine begin arriving later this month.

"We've been so confused over this, we didn't know what to do," Misch said. "We just got official warning that it's against the law."

In Misch's two practices, between 60 and 80 children are given their vaccinations -- for hepatitis, meningitis, polio -- each day, he said.

Private clinics primarily use medical assistants to handle vaccinations, and have been allowed to for decades, he said. But without their help, Misch said physicians in his practice have had to administer the injections themselves.

"In one day the vaccination of kids is grinding to a halt," he said.

The procedure can be time-consuming, he said, and nearly half of his patients have been turned away. They were referred to the Southern Nevada Health District, which he said already has its hands full.

Health District spokeswoman Stephanie Bethel said the district hasn't seen an unusual increase in patients waiting for immunizations as of yet.

It's been busier than usual, but that's because students are heading back to school and more need immunizations.

"It seems OK right now," Bethel said. "There hasn't been a rush of people."

But Kim LaMotte-Malone, a pediatrician with Anthem Hills Pediatrics, said she believes that could change for the health district in the coming weeks, especially with the H1N1 vaccine hitting offices soon.

"It's going to be very hard to accommodate the masses without the (medical assistants') help," she said.

It's unfortunate, she said, because she employs medical assistants who are well-trained and always supervised.

But without them, she's not going to be able to administer the vaccinations her practice has been deputized for.

"I'm going to probably have to refer a lot of the children to the state as well," she said.

Misch said if you suddenly "send a humongous number of patients ... into the state medical system, we could have a real problem on our hands."

And because of the high number of foreign visitors that come to Las Vegas each year -- with many countries' immunization laws being different -- the possibility that disease could spread is possible, he said.

"It hasn't sunk in to everyone outside of the medical community yet," he said. "Until a child dies from meningitis, then it'll be front page news."

Dan Burns, a spokesman for Gov. Jim Gibbons, said Gibbons had specifically asked the medical board about the vaccinations and immunization issue.

"They're confident about it. There will be enough qualified people who can give shots," Burns said. "The medical board consists of doctors and citizens who are very knowledgeable about the issue. At some point you have to trust their decisions."

Attempts to reach medical board executive director Louis Ling for comment Wednesday were unsuccessful.

The medical board's advisory came a day after District Judge Kathleen Delaney ruled the board violated the state's open meeting law during a Sept. 18 hearing to pass emergency regulations, which would have permitted medical assistants to give flu shots and other vaccines, but also prohibit them from administering injections of cosmetic drugs such as Botox.

The Botox issue and the issue over flu shots and vaccinations "should have been broken into two parts because they're separate," Misch said. "Now it could jeopardize the entire health of the state of Nevada."

Contact reporter Mike Blasky at mblasky@reviewjournal.com or 702-383-0283.