AANP (American Association of Naturopathic Doctors) on COVID-19 Vaccinations and the Role of Licenced NDs in the Pandemic.

The American Association of Naturopathic Doctors (AANP) is the national professional association representing licensed and licenseable naturopathic doctors (NDs) in the US.
Licensed naturopathic doctors are trained as primary care providers, who emphasize patient-centered, preventive healthcare and are strong proponents of the principles of shared decision making.
 
NDs and the COVID-19 Vaccines
With broader eligibility and availability of the vaccine and increased distribution channels, the AANP strongly advocates that naturopathic doctors have access to, and be able to administer, the COVID-19 vaccine where it is within their scope of practice. Fundamental to AANP’s strategic plan is to advocate for NDs to be licensed and recognized to practice to the fullest extent of their education and training throughout the US. Naturopathic Doctors are educated on standards of care for immunization, and vaccines are one of many tools used by naturopathic doctors to protect against infectious diseases as reflected in the Association of Accredited Naturopathic Medical Colleges Core Competencies on Immunization Education.
 
The Role of Licensed Naturopathic Doctors in the Pandemic
Public health guidelines such as social distancing, hand washing, and mask wearing have been prioritized in the last year as the nation has struggled to understand the nature of this disease. Despite these measures, morbidity and mortality from COVID-19 continues to be alarmingly high. Certain populations, including individuals with pre-existing chronic disease, those without sufficient access to comprehensive healthcare service, and people of color are disproportionately affected by COVID-19.
Even with the new vaccines, there are currently still important unknowns, including whether the vaccine prevents asymptomatic transmission, how long vaccine protection will last, what the impact of the vaccine will be on untested populations such as much older adults, pregnant women and children, and the extent of risk of allergic reaction and adverse events.
Because of these unknowns, and the simple fact that there are also populations that are vaccine hesitant or for whom the vaccine is currently not recommended by the CDC, it is of utmost importance to pursue additional pathways to further decrease the spread and the negative consequences of COVID-19. These additional pathways should include:
1.    Adding naturopathic doctors to plans to combat COVID-19. Licensed NDs work collaboratively within all medical settings, and in regulated states, NDs are integrated into health systems in both primary and specialty settings. The World Naturopathic Federation outlines how naturopathic doctors can help change the trajectory of this public health crisis. There is an increasing body of research on naturopathic practice, including how care by licensed naturopathic doctors can lead to better outcomes in the conditions that predispose individuals to severe cases of COVID-19, including those patients with diabetes[1],[2],[3],[4],[5],[6],[7],[8],[9], cardiovascular disease[10],[11],[12],[13],[14], obesity[15],[16] and more.
2.    Engaging naturopathic doctors to provide education about risk vs. benefit with vaccine-hesitant, vaccine-resistant individuals[17], as well as with other individuals who may not tolerate the current vaccines, or for whom the vaccine is not currently recommended by the CDC due to age or other reasons. These populations often seek care from naturopathic doctors and integrative medicine providers, who can help educate about vaccine safety and provide information related to vaccine ingredients, potential allergens, symptoms that may be representative of a healthy immune response, and potential adverse events.
 
Policy Changes That Need to Happen

1. Licensing NDs in all 50 states and US territories. Currently, 22 states, the District of Columbia, and the US territories of Puerto Rico and the US Virgin Islands have licensing or registration for naturopathic doctors. This pandemic has vividly exposed the weaknesses in our healthcare system and its severe shortages of trained providers. In addition to managing chronic diseases that contribute to worse COVID-19 outcomes, naturopathic medicine is particularly well poised to provide supportive care to patients with mild to moderate symptoms of COVID-19 to help them recuperate at home, freeing up hospital resources needed for the critically ill. Naturopathic doctors are also well equipped to contribute to primary care needs, including desperately needed mental health services.
   
2. We strongly urge every state to fast-track licensure of naturopathic doctors to the full extent of their education and training, and to engage NDs into healthcare teams to address lifestyle factors and underlying chronic diseases to ease the burden of emergency COVID-19 cases overwhelming our hospital systems.
   
3. Immediate funding for large multicenter clinical trials via the FDA’s Coronavirus Treatment Acceleration Program to evaluate natural medicine therapies that are low-cost, readily available, and that have already shown promising results in strengthening host immunity in similar viral infections. Some natural products to consider include: Vitamin C, Vitamin D, Zinc, Sambucus nigra, among others, as well as other strategies to support gut microbiota linked to improved outcomes for COVID-19.
4. Urging federal and state regulatory agencies to dialogue with integrative medicine providers to support freedom of speech and sharing of factual medical information for the purposes of expanding patient education about evidence-based, natural medicine approaches to the prevention and potential mitigation of COVID-19.

 
In summary, licensed naturopathic doctors play a valuable role as front-line, primary healthcare providers but are limited by lack of licensure in all 50 states. Their patient-centered communication, comprehensive training in prevention-oriented primary care, and unique expertise in evidence-based integrative and natural health, provides effective treatment of chronic diseases and supports immune health in a manner that may be able to lessen the burden of COVID-19 morbidity.