Aerosol-generating Procedures Research Articles

COVID-19 Impact on Community-Based Participatory Randomized Controlled Trials-Lessons From the Oral Health Disparities in Children Consortium.

The COVID-19 pandemic has had a major impact on nearly every sector of science and industry worldwide, including a significant disruption to clinical trials and dentistry. From the beginning of the pandemic, dental care was considered high risk for viral transmission due to frequent aerosol-generating procedures. This resulted in special challenges for dental providers, oral health care workers, patients, and oral health researchers. By describing the effect that the COVID-19 pandemic had on four community-based randomized clinical trials in the Oral Health Disparities in Children (OHDC) Consortium, we highlight major challenges so researchers can anticipate impacts from any future disruptions.

Aerosol-generating Procedures and Decision Drivers for COVID Pre-procedure Testing

Introduction: SARS-CoV-2 is thought to spread between individuals in close contact, primarily through respiratory droplets, including asymptomatic individuals [1,2]. The virus has been shown to persist in aerosols for hours [3]. Aerosol-generating procedures may increase the risk of transmission to healthcare providers, potentially putting dentists and patients at greater risk of exposure [3]. Current CDC guidelines for dental professionals include: N95 or higher-level respirator use during aerosol-generating procedures; COVID screening and triaging of patients; hand and respiratory hygiene best practices; facility updates; and physical distancing. The CDC also recommends considering pre-procedure testing to identify pre- and asymptomatic patients [2]. Methods: In June 2020, New Jersey health centers Zufall Health and CHEMED implemented COVID-19 testing prior to aerosol-generating dental procedures, along with other protocols, as part of the safe reopening of their facilities. They utilized screening and testing to safeguard dental staff and patients, to calm anxious front-line employees, and to facilitate patient follow-through on dental care. In September 2020, the centers undertook additional process improvements to determine the continued viability of pre-procedure COVID testing in their dental facilities. Results: From September 2020 to March 2021, the centers found parity between their COVID testing methods. Testing results were similar, indicating very few asymptomatic dental patients tested positive. Staff treating patients later determined positive for COVID were not infected. Conclusions: In an area of low, moderate, and high transmission, providers can feel confident that stringent adherence to recommended COVID precautions can safeguard staff and patients, including during aerosol-generating dental procedures. While testing is an important public health tool and helpful in reassuring staff and patients, one center determined it was no longer necessary to the safe and effective delivery of dental services. By the completion of the project, the other center was evaluating halting pre-procedure testing, and has since stopped testing.

Impact of COVID-19 pandemic on hip fractures: the central London experience COVID-related urgent geriatric hip trauma (COUGH) study COVERT ( COVid Emergency-Related Trauma and orthopaedics) collaborative

IntroductionCOVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database (NHFD) in two large central London hospitals.Materials and methodsA multi-center, longitudinal, retrospective, observational study of NOFF patients was performed for the first ‘golden’ month following the lockdown measures introduced in mid-March 2020. This was compared to the same time period in 2019.ResultsA total of 78 cases were observed. NOFFs accounted for 11% more of all acute referrals during the COVID era. There were fewer overall breaches in KPIs in time to theatre in 2020 and also for those awaiting an orthogeriatric review. Time to discharge from the trust during the pandemic was improved by 54% (p < 0.00001) but patients were 51% less likely to return to their usual residence (p = 0.007). The odds ratio was significantly higher for consultant surgeon-led operations and consultant orthogeriatric-led review in the post-COVID era. There was no significant difference in using aerosol-generating anaesthetic procedures or immortality rates between both years.ConclusionThe impact of COVID-19 pandemic has not adversely affected the KPIs for the treatment of NOFF patients with significant improvement in numerous care domains. These findings may represent the efforts to ensure that these vulnerable patients are treated promptly to minimize their risks from the coronavirus.

Interim Guidance for Emergency Medical Services Management of Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic.

Interim Guidance for Emergency Medical Services Management of Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic.

Life Plus Mini Capsule S®, Novel Intubating Box – A Pilot Study

To protect clinicians without access to recommended personal protective equipment during aerosol-generating procedures such as endotracheal intubation, various products have been introduced to clinical practice. The authors would like to present a pilot study with a novel intubating box, the LIFE PLUS MINI CAPSULE S®, which has improved systems to prevent the egress of particles from the box as well as a built-in HEPA (High Efficiency Particulate Air) aspiration filter. Nineteen anesthesiologists simulated endotracheal intubation on a mannequin in test conditions with and without using the LIFE PLUS MINI CAPSULE S®. All anesthesiologists successfully intubated the mannequin at first attempt, and there were no failed intubations. The median (range) intubation time was 9.1 (2.0–25.0) seconds longer when the LIFE PLUS MINI CAPSULE S® was used, and there were no breaches of personal protective equipment. The leakage of airborne particles was analyzed using a Qualitative and a Quantitative Fit Test. Although our pilot study shows promising results, further research is required to validate our results in vivo and in a larger sample size which will provide us with a better insight into the efficacy and applicability of this safety tool in emergency and elective clinical conditions.

Narrative Review of Tracheostomy Procedure during COVID-19 Pandemic

The COVID-19 pandemic has led to an unprecedented increase in the number of critically ill patients requiring mechanical ventilation. Tracheostomy played an important role to wean off the patients from ventilator support and maximize the resources. Tracheostomy is an aerosol generating procedure (AGP) which raised some controversial issues as it carries a risk of infection to healthcare workers. This study aims to review the issues related to tracheostomy procedure in COVID-19 patients, including the appropriate time to perform tracheostomy, criteria for patient selection, safer approach and risk of infection among healthcare workers. Related information retrieved via online search of original articles, paper reviews, recommendations and guidelines from PubMed, Medline and Google Scholar using keywords tracheostomy, COVID-19, intensive care and mechanical ventilation are summarized in this article. The suggested time frame to perform tracheostomy ranged from 7 to 21 days. Early tracheostomy performed between day 10 to 14 had beneficial outcome for the patients and helped to reduce ICU occupancy. Decision for appropriate timing was made after considering the viral load and the course of the disease. Criteria for patient selection based on suggestions from studies and guidelines were lower oxygen requirement (FiO2&lt;0.4, PEEP&lt; 10), low Sepsis Related Organ Failure (SOFA) scores, ventilation for at least 10 days and signs of improvement. Patient factors, availability of facilities and expertise were important criteria for decision to undertake tracheostomy. The patient outcomes from tracheostomy varied between centers. Most of the studies reported that none of the healthcare workers had been infected by utilizing appropriate PPE and by taking important precautions during the procedure. In conclusion, guidelines were established for tracheostomy procedure during COVID-19 but the decision to undertake the procedure still depend on a case by case basis.

Visual or visual-tactile examination to detect and inform the diagnosis of enamel caries.

Visual or visual-tactile examination to detect and inform the diagnosis of enamel caries.

Indoor Air Quality and Environmental Sampling as Support Tools to Detect SARS-CoV-2 in the Healthcare Setting.

Objectives:To evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread inside the healthcare setting using environmental sampling and indoor air quality (IAQ) parameters.Methods:Ward/ICU rooms had IAQ parameters monitored in real-time, including volatile organic compounds and particulate matter. Surface and three air samples with different exposure times were collected in each room and tested for SARS-CoV-2 using quantitative Rt-PCR. Environmental sampling and IAQ data were compared to provide information about viral spread.Results:SARS-CoV-2 RNA was detected in 6/10 rooms and 9/30 air samples, which is proportionally higher than previous studies. Sampling time confirmed to be crucial to viral detection. No correlations between IAQ parameters could be associated with positive/negative samples even when aerosol-generating procedures were performed.Conclusion:Environmental sampling of SARS-CoV-2 RNA may be used as an indicator of occupational safety. IAQ is also a potential tool but requires further research.

Adherence to Personal Protective Equipment Guidelines During the COVID-19 Pandemic Among Health-Care Personnel: A Louisiana Case Study.

The aim of this study was to determine the extent that appropriate personal protective equipment (PPE), per Centers for Disease Control and Prevention (CDC) guidance, was used during the coronavirus diseases 2019 (COVID-19) pandemic by health-care personnel (HCP) in Louisiana in 5 clinical settings. An online questionnaire was distributed to the LA Nursery registry. Appropriate use of PPE in each of the 5 clinical scenarios was defined by the authors based on CDC guidelines. The scenarios ranged from communal hospital space to carrying out aerosol generating procedures (AGPs). A total of 1760 HCP participated between June and July 2020. The average adherence in LA was lowest for the scenario of carrying out AGPs at 39.5% compliance and highest for the scenario of patient contact when COVID-19 not suspected at 82.8% compliance. Adherence among parishes varied widely. Commentary to suggest a shortage of PPE supply and the practice of re-using PPE was strong. Use of appropriate PPE varied by setting. It was higher in scenarios where only face masks (or respirators) were the standard (ie, community hospital or when COVID-19 not suspected) and lower in scenarios where additional PPE (eg, gloves, eye protection, and isolation gown) was required.

Portable HEPA Purifiers to Eliminate Airborne SARS‐CoV‐2: A Systematic Review

Current epidemiologic predictions of COVID-19 suggest that SARS-CoV-2 mitigation strategies must be implemented long-term. In-office aerosol-generating procedures pose a risk to staff and patients while necessitating examination room shutdown to allow aerosol decontamination by indwelling ventilation. This review summarizes the current state of knowledge on portable high-efficiency particulate air (HEPA) purifiers' effectiveness in eliminating airborne SARS-CoV-2 from indoor environments. Medline, Embase, Cochrane Databases, and the World Health Organization's COVID-19 Global Literature on Coronavirus Disease. Data sources were systematically searched for original English-language published studies indexed up to January 14, 2021 per the following search strategy: ("HEPA" OR "High-efficiency" OR "High-efficiency particulate air" OR "Efficiency particulate" OR "Purifier" OR "Filter" OR "Cleaner" OR "Filtration") AND ("COVID" OR "COVID-19" OR "SARS-CoV-2" OR "Coronavirus"). Additional relevant studies were identified by searching the reference lists of included articles. Eleven published studies have evaluated the effectiveness of portable HEPA purifiers in eliminating airborne SARS-CoV-2 with relevantly sized surrogate particles. Ten studies evaluated aerosols and submicron particles similar in size to SARS-CoV-2 virions. In all studies, portable HEPA purifiers were able to significantly reduce airborne SARS-CoV-2-surrogate particles. The addition of portable HEPA purifiers augmented other decontamination strategies such as ventilation. Experimental studies provide evidence for portable HEPA purifiers' potential to eliminate airborne SARS-CoV-2 and augment primary decontamination strategies such as ventilation. Based on filtration rates, additional air exchanges provided by portable HEPA purifiers may be calculated and room shutdown times potentially reduced after aerosol-generating procedures.

COVID-19 in Dental Settings: Novel Risk Assessment Approach.

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and this emergency led to postponing elective dental care procedures. The postponing aimed to protect the public from an unknown risk caused by COVID-19. At the beginning of the outbreak, for public health authorities, the aerosol-generating procedures and the close proximity between dental care workers and patients in dentistry represented sufficient justification for the delay of dental visits. Dental care is a priority, and for many years, studies have proven that the lack and delay of dental care can cause severe consequences for the oral health of the general population, which can cause a high global burden of oral diseases. Safety is necessary while resuming dental activities, and risk assessment is an efficient method for understanding and preventing the COVID-19 infectious threats facing the dental industry and affecting dental care workers and patients. In this study, for safe dental care delivery, we adapted risk assessment criteria and an approach and an occupational classification system. Based on those tools, we also recommend measures that can help to minimize infectious risk in dental settings.

Reducing Intervention in the COVID-19 Era: Opportunities for Vital Pulp Treatment

Over the last 12 months, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) virus has emerged as a significant global health problem with extensive repercussions for the practise of dentistry. As the principle transmission-route is via droplet-spread, aerosol-generating dental procedures (AGPs) present an exquisite challenge, which either has to be avoided or performed using strict infection-control measures, which increase the deployment of resources and cost. This new working environment necessitates the adoption of simplified, yet effective procedures that reduce intervention and minimise clinical chair time to short, single visits. Vital pulp treatment (VPT) has emerged as an attractive, technically less-complicated group of biologically-based management strategies that are aimed at maintaining pulp vitality and avoiding root canal treatment (RCT). These procedures are carried out in a strict aseptic environment using a rubber dam and have a reported high success rate, suggesting that they could be considered as effective and simple alternative therapies to relieve pain and avoid multiple visit RCT and other endodontic procedures. The relevance of promoting a simple, predictable and effective alternative to traditional, more complex dentistry has never been more compelling. In this perspective article, the latest advances in VPT are highlighted, along with an analysis of their relative success and compelling reasons why we as dentists should be adopting these treatment approaches. Thereafter, case selection, prognostic factors, techniques, limitations and future prospects of these procedures are discussed.

A Review of Aerosol Generation Mitigation in International Dental Guidance

IntroductionThe coronavirus disease 2019 (COVID-19) led to the worldwide closure of dental practices or reduction of dental services. By the end of April 2020, governments and professional organisations were publishing recommendations or guidance for the reopening/restructuring of dental services. The aim of this study was to assess how dental aerosol-generating procedures (AGPs) were defined in international dental guidelines, what mitigation processes were advised, and whether they were linked to COVID-19 epidemiology. MethodsElectronic searches of a broad range of databases, along with grey literature searches, without language restriction were conducted up to 13 July 2020. Recommendations for the use of face masks and fallow times with patients without COVID-19 were assessed against the deaths per 1 million population in the included countries and country income level using Pearson Chi-squared statistics. ResultsSixty-three guidance documents were included. Most (98%) indicated that AGPs can be performed with patients without COVID-19 with caveats, including advice to restrict AGPs where possible, with 21% only recommending AGPs for dental emergencies. Face masks were recommended by most documents (94%), with 91% also specifying the use of goggles or face shields. Fallow periods for patients without COVID-19 were mentioned in 48% of documents, ranging from 2 to 180 minutes. There were no significant differences in recommendations for face masks or fallow time in patients without COVID-19 by country death rate (P = .463 and P = .901) or World Bank status (P = .504 and P = .835). Most documents recommended procedural or environmental mitigations such as preprocedural mouthwash (82%) and general ventilation (52%). Few documents provided underpinning evidence for their recommendations. ConclusionsWhile the amount of high-quality direct evidence related to dentistry and COVID-19 remains limited, it is important to be explicit about the considered judgements for recommendations as well as generate new evidence to face this challenge.

Comparison of intravascular access methods applied by nurses wearing personal protective equipment in simulated COVID-19 resuscitation: A randomized crossover simulation trial.

BackgroundPrehospital emergency care of children is challenging. In the era of the COVID-19 pandemic, when medical personnel should use personal protective equipment against aerosol-generating procedures, the efficiency of medical procedures may decrease. The study objective was to evaluate the effectiveness of different intravascular access methods applied by nurses wearing biosafety Level-2 suits in simulated paediatric COVID-19 resuscitation.MethodsA prospective, randomized, crossover, single-blinded simulation trial was performed. Nursing staff attending Advanced Cardiovascular Life Support courses accredited by the American Heart Association participated in the study. A total of 65 nurses were recruited and randomly assigned to different study groups. They received standard training on intravascular access methods employing distinct devices. The participants wore biosafety Level-2 suits and performed vascular access with the following intraosseous devices: NIO-P, EZ-IO, and Jamshidi needle; intravenous (IV) access was used as a reference method. Both the order of participants and the access methods were random. Each participant performed intravascular access with each of the four methods tested. The effectiveness of the first attempt to obtain intravascular access and the following time parameters were analysed: the time between grasping the intravascular device out of the original packing until infusion line connection. The ease of the procedure was measured with a visual analogue scale (1 – easy; 10 – difficult).ResultsThe first attempt success rate of intravascular access by using NIO-P and EZ-IO equalled 100% and was statistically significantly higher than that with the Jamshidi needle (80.0%; p = 0.02) and with the IV method (69.2%; p = 0.005). The time required to connect the infusion line varied and amounted to 33 ± 4 s for NIO-P compared to 37 ± 6.7 s for EZ-IO (p<0.001), 43 ± 7 s for Jamshidi (p<0.001), and 98.5 ± 10 s for IV access (p<0.001). The procedure was easiest in the case of NIO-P and EZ-IO (2 ± 1 points; p=1.0) compared with Jamshidi (5 ± 3 points; p<0.001) and IV access (7 ± 2 points; p<0.001).ConclusionThe study provides evidence that nurses wearing biosafety Level-2 suits were able to obtain intraosseous access faster and more effectively as compared with IV access during simulated COVID-19 paediatric resuscitation. The most effective method of intravascular access was the NIO-P intraosseous device. Further clinical trials are necessary to confirm the results.

Restarting endoscopy services in Pakistan, in the covid era: The way forward

Background: The emergence of SARS-COVID2 has completely reshaped the way we go about our daily business. Apart from other services, this has also impacted healthcare services and the way they are delivered. As endoscopy is an Aerosol generating procedure(AGP) with high risk of transmission, multiple endoscopy societies at the peak of the pandemic published guidelines on prioritizing of endoscopy services according to the urgency, highlighting the clinical indications which could be deferred until a more comprehensive plan is put out to safely perform endoscopy procedures or the infection rates drop down. &#x0D; Aims and Objectives: We give an example of how our unit in a low Human development Index country, worked through the peak of pandemic providing service to patients in a safe manner which can be continued forward until the pandemic runs its course. &#x0D; Materials and Methods: This prospective study was performed at Dr. Ziauddin University Hospital, Karachi. The ethical endorsement was taken from the Ethical Review Committee. Informed consent was secured in writing from each participant.Patients were assessed by a given screening questionnaire and COVID RT PCR of every patient was checked before endoscopy procedures, only those who tested negative were included in the study. Theendoscopy consultant, endoscopy trainee, anesthetist and the endoscopy staff along with the patients were reassessed for signs &amp; symptoms of COVID-19 via a telephonic questionnaire, 2 weeks after the procedure. &#x0D; Results : Total 80 patients were assessed, out of which 60 were males. All the patients had negative COVID-19 PCR at the time of endoscopy. The procedures were performed under propofol sedation with full Personal protective equipment (PPE) both for the endoscopist and the staff in the room. The PPE included N95 masks, hairnet, Face visor, surgical gloves and disposable gowns. 2 weeks post procedure both the patients and the endoscopy staff were assessed via telephonic questionnaire for any signs &amp; symptoms of COVID-19 or any positive COVID PCR since the time of endoscopy.&#x0D; Conclusion: SARS-COVID 19 pandemic is far from over. There is a dire need to restart endoscopy services in a safe and effective way. Ideally full PPE and negative pressure rooms for AGP is the way forward considering that quite a few patients are asymptomatic carriers and the dismissal rate of COVID PCR pick up rate .In low socioeconomic countries these facilities are not readily available. Hence doing a COVID PCR prior to the procedure with adequate PPE can be used as a way forward in COVID era until the pandemic is over.

COVID-19: dental aerosol contamination in open plan dental clinics and future implications.

Study design An experimental study design was used to investigate the spread of splatter/aerosol during simulated dental procedures on a mannequin in open plan clinic and dental clinical teaching laboratory settings. All experiments were based on crown preparation of an artificial maxillary central incisor using a high-speed air turbine over a ten-minute period. Fluorescein dye was introduced into the irrigation system of the handpiece (model 1) and the mannequin's mouth was used to simulate salivary flow (model 2) under varying experimental conditions (suction flow rate, cross ventilation and exposure time). Six experiments were conducted in the open plan clinic while three experiments were undertaken in the clinical laboratory. Customised rigs with collection platforms consisting of filter papers were placed in open plan bays and adjacent walkways. Samples were also collected from a 400 cm2 area in each of the eight adjacent bays. Time course experiments repeated the same procedures on three occasions in a clinical laboratory and utilised a rig with eight four-metre rods supporting collection platforms around a dental mannequin. The distribution of fluorescein dye was analysed by fluoroscopy and spectrofluorometry.Results Contamination levels showed variations under different experimental conditions. In the absence of suction and cross ventilation, contamination was observed at large distances. Use of suction reduced contamination in the operating bay by 53% and 81.83%, while cross ventilation reduced contamination in adjacent and distant areas by 80-89%. Minimal contamination was detected at a distance of >5 m from the operating bay, with the use of medium-volume suction demonstrating that 1.5-metre-high partitions with open fronts limit 99.99% of splatter from aerosol generating procedures (AGPs) to the operating bay. Minimal additional aerosol contamination was detected ten minutes after the procedure.Conclusions Contamination from dental AGPS has the potential to contaminate distant sites in open plan clinics. Risk of cross infection is small if the bays are >5 m apart and contamination can be minimised with the use of suction and cross ventilation.

Aerosol transmission and COVID-19: overview

SARS-CoV 2, the agent of the disease known as COVID-19, appeared in China at the end of 2019. The virus is transmitted primarily through the air in droplets or microdroplets emitted by symptomatic (through coughing or sneezing or during aerosol-generating procedures) or asymptomatic (through breathing or speaking) infected persons. This article reviews the current knowledge about the sizes of droplets emitted, the quantity of viral particles potentially emitted, the parameters influencing the conditions of transport and survival of these viral particles, including atmospheric conditions, and the impact on the development of the disease. It also discusses the parameters of risk assessment and recommendations for ventilation of indoor spaces. © 2021 John Libbey Eurotext. All rights reserved.

Second wave of COVID-19 pandemic and the surge of mucormycosis: Lessons learnt and future preparedness: Indian Society of Anaesthesiologists (ISA National) Advisory and Position Statement.

Second wave of COVID-19 pandemic and the surge of mucormycosis: Lessons learnt and future preparedness: Indian Society of Anaesthesiologists (ISA National) Advisory and Position Statement.

“PRACTICE MODIFICATIONS PRELIMINARY TO PERIODONTAL TREATMENT DURING COVID-19 PANDEMIC BY THE ORAL HEALTH CARE PROVIDERS TO CONTAIN ITS SPREAD: A QUESTIONNAIRE SURVEY.”

Introduction: Oral health care providers should make some serious practice modications to curb the spread of COVID-19 in a dental setting, especially before periodontal treatment, due to the unique characteristics of dental procedures, a large number of droplets and aerosols are generated. We aimed to evaluate the knowledge, perception, attitude and awareness about the COVID-19 pandemic, practice modications made by oral health care providers (OHP) before periodontal therapy. Methods: A 25 Item questionnaire was structured and distributed among oral health care providers. A convenient sampling method was used for data collection (n=251), and the distribution of responses was presented as frequencies and percentages. Results: 251 participants out of whom 69.7% were 20-30 years, 6.8% of them were above 50 years of age and the male to female ratio 1:1.5, their educational status was BDS 44.6%, MDS 40.6% and Diploma in dental hygiene 14.8%, who mainly were practicing in urban dental setting (66.1%) their total Knowledge score was 6 (Bloom's criteria) and their source of data was WHO guidelines (78%). Personal Protective Equipment, used while performing aerosol-generating procedures for treating periodontal diseases, was disposable type 85% and reusable were only 15%. Audiovisual clips,Pamphlets, andPosters/Bannerswereusedby54.2%toeducatepatientsregardinglimitingthe spreadofCOVID-19. Conclusion: There is a need for regular educational interventions and training programs on infection control practices for COVID-19 across all oral healthcare professionals. Efcient and practical strategies are required by OHPto prevent, control, and contain the spread of COVID-19.

Coronavirus disease 2019 (COVID-19) vaccines: A concise review.

The development of a successful vaccine against severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), the agent of coronavirus disease 2019 (COVID‐19), in an unmatched period of ten months, is a tribute to human ingenuity in the face of a vicious pandemic. A return to pre‐pandemic “normalcy” depends on the successful delivery of the vaccine to a majority (~70%) so as to develop herd immunity critical to arrest the community spread of infection. Vaccination against COVID‐19 is particularly important for dentistry as the dental team works in an environment replete with aerosol‐generating procedures (AGP) that facilitate virus spread. Hence, a COVID‐19 vaccine is likely to be an obligatory requirement for the dental practice, and the latest addition to the extensive list of vaccines required for dental professionals for the safe delivery of dental care. Here, we review the currently available major candidate vaccines against SARS‐CoV‐2 and their benefits and risks. These include the vaccines developed on next‐generation platforms (mRNA, DNA, and viral vector vaccines), and the classic platforms (the live‐attenuated virus, and the protein subunit vaccines) The review concludes with a summary of impending issues and challenges facing the provision of COVID‐19 vaccines for all stakeholders in dentistry.