Immunization

Naturopathic physicians in British Columbia may only prescribe and administer vaccines if they are certified to do so.

Naturopathic Physicians’ Scope of Practice – Administration of Vaccines

Naturopathic physicians compound, dispense or administer immunoprophylactic agents only under the following circumstances:

Naturopathic physicians who compound, dispense or administer immunoprophylactic agents identified by the BC Centre for Disease Control (BCCDC) must possess the competencies established by the BCCDC and follow decision support tools established by BCCDC.

Qualification Requirements for Certification

In order to apply for certification to administer vaccines, naturopathic physicians must:

• Have the status of full registration under s. 46 of the College’s Bylaws;
• Be certified in Prescriptive Authority; and
• Have completed the BCCDC online immunization competency course (see link, above).

Application Process

Once registrants have successfully fulfilled the qualification requirements, they may apply to the College for certification to administer vaccines by submitting proof of certification requirements to the College office within one year of taking the course and a declaration that they have read and understand the College’s Standards, Limits and Conditions for immunization.

Applications will be reviewed by the College as they are received, and qualified applicants will be notified of their five-year certification, which must be received prior to providing vaccination services.

Standards, Limits and Conditions for Immunization

Standards

1. Obtain informed, written consent from the patient or patient’s agent with regard to:

• Name of the vaccine to be administered
• Disease prevention or treatment of anaphylaxis
• Benefits and risks of the vaccine
• Expected reactions
• Usual and rare side effects
• Rationale for the 15-30 minute wait period following the injection

2. Prepare and provide care of the injection site including:

• Assessment of the injection site
• Selecting and land-marking the injection site
• Determining the requirement for dressings

3. Prepare the injection for administration including:

• Using aseptic technique in preparation and administration of the injection
• Checking the drug product and expiry date
• Determining the stability / compatibility
• Assembling appropriate equipment and supplies (syringes, needles and administration sets)
• Drawing the injection product from the vial or ampoule
• Maintaining asepsis throughout the process
• Applying universal precautions
• Properly storing prepared injections / solutions

4. Document history, assessment and injections administered including but not limited to:

• Drug, dose and lot number given
• Route of administration
• Date and time of administration
• Patient response (before, during and following the 15-30 minute wait period)
• Patient or patient’s agent contact information
• Provide patient or patient’s agent with the administering naturopathic physician’s contact information
• Patient teaching done (adverse reactions and management and plans for follow-up)

5. Implement appropriate emergency measures including but not limited to:

• Performing basic first aid procedures
• Using adrenalin / epinephrine
• Performing CPR
• Establishing procedures for handling sensitivity anaphylactic reactions
• Managing needle stick injuries

6. Develop, maintain and review, at least annually, a policy and procedure manual including but not limited to:

• Emergency procedure protocol
• Emergency treatment protocol including the following minimum equipment or supplies:
– Adrenalin / epinephrine and appropriate syringes for administration
– Diphenhydramine
– Appropriate equipment including a resuscitator bag to maintain airways including adult and child airways
• Precautions required for patients with latex allergies

7. Maintain a setting within which the injection is to be administered that is clean, safe, comfortable and appropriate private and furnished for the patient

8. Notify and provide relevant information to other health professionals, as appropriate. Registrants will be guided by current standards, limits and conditions for referrals to a medical doctor, as set out in the College’s “Scope of Practice: Standards, Limits and Conditions for Prescribing, Dispensing, and Compounding Drugs,” at p. 21, “Physician Consultation and Referral,” which can be found on the CNPBC website (www.cnpbc.bc.ca).

Limits

  1. A naturopathic physician must not administer an immunization to a child under five (5) years old.
  2. Registrants who become certified after successful completion of the BCCDC online course must possess the competencies established by the BCCDC and follow the decision support tools established by the BCCDC.

Conditions

  1. Only naturopathic physicians who are on the Full Registration register of the College and who have Prescriptive Authority certification may apply for authorization to administer vaccines.
  2. A naturopathic physician must apply to the College for authorization to administer vaccines within one year of successful completion of the required training program.
  3. A naturopathic physician must receive notification from the College of their authorization prior to administering a vaccine.
  4. When a naturopathic physician chooses to administer a vaccine, the injection must be performed in accordance with the standards established by the College and within the limits of each naturopathic physician’s own competencies.