AVMA Updates

COVID-19 Vaccination Campaign Launch

On Monday, AVMA launched a targeted campaign to encourage members, the veterinary healthcare team, and clients to get vaccinated against COVID-19 if they are able. This campaign was encouraged by the CDC, as the agency recognizes the key role veterinarians play in society and public health. You may see campaign elements in your email, social media feeds, through advertising on websites that you visit, in your mailbox, or even on digital screens at various businesses.

As veterinarians, we understand the power of vaccines and are uniquely qualified to share their importance in preventing and controlling disease, and we have created a variety of materials for members to use in sharing this information in their practices and communities. These include posters for practice lobbies and back office areas, client handouts, talking points for discussing the vaccine with clients or the public, an FAQ about the vaccine itself, language you can use for on-hold messages or on appointment reminders and videos. Many of the materials offer multiple versions featuring veterinarians interacting with various animal species, so that they are relevant to different audiences. Physical campaign materials will be mailed the week of December 3rd to practices located within geographic areas that have been reported by the CDC to have lower vaccination rates. You are invited to view www.avma.org/VaccinationTools to view and download any of these materials.

We fully understand that not every veterinarian will be comfortable discussing the COVID-19 vaccine, and that every encounter with a colleague or client simply isn’t going lend itself to a conversation about vaccination against COVID-19. The resource materials are intended to make that conversation easier for those who are comfortable and do want to take the opportunity to discuss it with their colleagues and clients.

Please let us know if you have any questions.

Thank you,

Dr. Gail Golab
Chief Veterinary Officer

Angela Roberts
Chief Marketing and Communications Officer

American Veterinary Medical Association

News from the AVMA

Article of Interest in JAVMA Sept. 15th:

“Are we in a veterinary workforce crisis?” Understanding our reality can guide us to a solution. This commentary written by AVMA Chief Economist, Matthew Salois and AVMA Chief Veterinary Officer, Gail Golab addresses the Veterinary practitioners feeling like there are not enough hours in the day – a consequence of “pandemic pets” and shortage of veterinarians. The article highlights the data and the steps that can help navigate the challenges affecting our profession.

Volunteer Opportunities at the AVMA

The American Veterinary Medical Association invites you to explore the Committee and Council positions available this year and in 2022. Please visit the Volunteer Opportunities section of the AVMA website to learn more. Nominations for currently vacant positions are being accepted on an ongoing basis until those positions are filled. For positions expiring in August 2022, the deadline to submit nominations for Committee positions is March 31, 2022, and the deadline to submit nominations for Council positions is May 1, 2022.
Requirements:
· All Committee nominations must include the Nomination Form and a 1-2 page resume.
· For Councils, a nomination is considered complete when each of the following has been received: Nomination Form, Campaign Guide document, photo and 2-minute video.
Please submit all nominations via email to OfficeEVP@avma.org. If you have a question or would like to learn more about a specific entity, please contact OfficeEVP@avma.org or 847-285-6605. I hope you will consider applying for these volunteer positions! https://www.avma.org/membership/volunteering-avma

Calling all leaders – Rising leaders, Experienced leaders and Presiding Leaders

The Veterinary Leadership Conference (VLC) is the veterinary profession’s premier conference for leadership development. You will have the opportunity to attend CE sessions, AVMA governance meetings, and networking with colleagues to expand and develop your leadership skills. Join us, for VLC January 6-9, 2022, at the Chicago Marriott Downtown Magnificent Mile. A select amount of education sessions will also be available virtually.
https://www.avma.org/events/veterinary-leadership-conference

State Advocacy Committee (SAC)

As a member of this Committee, I can tell you that the AVMA is working hard on many topics essential to Veterinary Medicine. I have included a summary provided by the Government Relations Division here, to keep you updated on Congressional Bills. Please feel free to contact me with any questions you would like to discuss.

Leianne K. Lee Loy
ikaikavet@gmail.com
House of Delegate Representative from Hawaii and Member of SAC

Planning for 2022 – The AVMA Conference

July 29, 2022 – August 2, 2022
https://www.avma.org/events/avma-convention

AVMA Summer House of Delegates

The AVMA House of Delegates Meeting was held the last week of July. This meeting was in a hybrid format – attending live in Chicago or virtually. The agenda items included Resolutions, AVMA officer elections and House of Delegates Elections.

Highlights of elections:
Dr. Lori Teller from Texas, AVMA President-Elect
The AVMA Officers are now:
Dr. Jose Arce from Puerto Rico, President
Dr. Karen Bradley of Vermont, Board of Directors Chair
House Advisory Elections:
Dr. Rex Anderson of Montana, re-elected to the House Advisory
Committee (HAC), and then elected HAC Chair.
Future Elections:
Dr. Rena Carlson from Idaho and Dr. Grace Bransford from California
announced candidacies for the 2022-2023 President-Elect position
Dr. Jennifer Quammen of Kentucky announced her candidacy for the
position of 2022-2024 Vice President.

AVMA’s Veterinary Information Forum (VIF)
Topics presented by delegates/alternate delegates to address topics of concern in the profession, feedback and action items. This years topics were: “HOD Delegates as AVMA Brand Advocates: How to Best Communicate AVMA Member Value to our Constituents” and “Economic Dynamics in the U.S. Veterinary Workforce.”
Here is a summary of the VIF topics:
• How delegates can best communicate with their constituents – the HOD approved a resolution calling for the HOD’s House Advisory Committee to form a working group to explore and define delegates’ role as AVMA ambassadors in promoting AVMA member value, reporting back to the HOD at the next meeting (Resolution 15).
• Economic dynamics in the U.S. veterinary workforce – Your AVMA recognizes the economic, staffing, and morale challenges that currently exist in the U.S. veterinary workforce. Your AVMA is working on these problems and information will be available in JAVMA and the AVMA Veterinary Business and Economic Forum in October (Resolution 16)

The HOD also addressed the following Resolutions on the agenda for this meeting:
• Resolution 8 – Reclassifying Ventilation Shutdown Methods as Not Recommended: The HOD voted to refer the resolution to the AVMA Board of Directors for consideration by the AVMA Panel on Depopulation.
• Resolution 9 – Rules for Officer Election Campaigns: The HOD voted to adopt the resolution.
• Resolution 10 – Policy on Veterinary Compounding: The HOD voted to refer the resolution to the AVMA Board of Directors for further clarification by the AVMA Council on Biologic and Therapeutic Agents.
• Resolution 11 – Revised Policy on Use of Random-Source Dogs and Cats for Research, Testing, and Education: The HOD voted to adopt the resolution.
• Resolution 12 – Revised Policy on Veterinary Foresight and Expertise in Antimicrobial Discussions: The HOD voted to adopt the resolution.
• Resolution 13 – Revised Policy on Notification to the Veterinarian of Violative Residues in Foods of Animal Origin: The HOD voted to adopt the resolution.
• Resolution 14 – Policy on Use of Prescription Drugs in Veterinary Medicine: The HOD voted to refer the resolution to the AVMA Board of Directors for referral to the AVMA Council on Biologic and Therapeutic Agents for further clarification.

AVMA Update – April 2021

Aloha Colleagues!

Before I share with you the many programs the American Veterinary Medical Association has available for all members, I did want to take this opportunity to send a huge virtual Mahalo to you for your support of my candidacy for the AVMA Board of Directors District X Representative. Although I was not chosen, I am grateful to have been on the ballot – Mahalo!

We, Carolyn Naun (alternate delegate) and I (Delegate and State Advocacy Committee Member), will continue to represent Hawaii proudly at the House of Delegate meetings. If there are any questions or concerns, please feel free to contact us.

Aloha,
Leianne K. Lee Loy

Highlights from the AVMA:

AVMA Virtual Convention July 29 – August 1, 2021: Registration is open!
Check out “Convention at First Glance” to discover the over 300 hours of
continuing education. avmaconvention.org

VLC (Veterinary Leadership Conference) January 7-9, 2022 avma.org/vlc
(NOTE: Please click here for highlights of the AVMA House of Delegates Winter Session including the Veterinary Information Forum that took place during the VLC.) This is a great conference to develop, improve and perfect your leadership skills.

COVID-19 resource center: www.avma.org/Coronavirus
More information about veterinarians’ ability provide vaccines
E-book: COVID-19: Meeting the Challenge

AVMA Axon online platform – digital education https://axon.avma.org
Certificate Programs, Webinars, My Veterinary Life Podcasts Series

AVMA Trust Retirement Plan avmalifeplans.com/ARP
For questions, or to schedule a personal consultation, email AVMATrustRetirementPlan@transamerica.com or call
312-596-5336.

AVMA, VetSuccess Partnership
• Veterinary Industry Tracker
• To learn more about the AVMA’s economics resources, visit
avma.org/VeterinaryEconomics

Diversity, Equity, and Inclusion: avma.org/diversity

Telehealth
• AVMA Guidelines for the Use of Telehealth in Veterinary Practice
• 2021 AAHA/AVMA Telehealth Guidelines for Small-Animal Practice

Veterinarians as COVID-19 Vaccinators

Submitted by the American Veterinary Medical Association

The AVMA has been working hard for the past few months, as veterinarians have been increasingly discussed as needing to be among those able to assist in efforts to vaccinate people against COVID, to have veterinarians specifically included in the declarations under the federal Public Readiness and Emergency Preparedness Act (PREP Act), which authorizes the HHS Secretary to issue emergency public health declarations and provides limited immunity from liability to those covered under the act.

As of March 12, 2021, veterinarians and veterinary students are included in the PREP Act:

· It allows veterinarians who are licensed to practice under the law of any state to administer COVID vaccines in any jurisdiction in association with a COVID vaccination effort by a state, local, tribal, or territorial authority or by an institution in which the COVID vaccine is administered.

· This also applies to veterinarians who have held an active license or certification under the law of any state within the last five years which is inactive, expired or lapsed, as well as veterinary students with appropriate training in administering vaccines. The intent is to include recently retired veterinarians who may want to help.

· Today’s amendment preempts any state law that would otherwise prohibit veterinarians or veterinary students who are a “qualified person” under the PREP Act from prescribing, dispensing, or administering COVID vaccines or other covered COVID countermeasures.

· Veterinarians and veterinary students will be afforded liability protections in accordance with the PREP Act and the terms of the amendment. However, specific conditions must be met in order for the authorization to administer the vaccines and the liability protections to apply. These liability protections apply from March 11, 2021, through October 1, 2024.

· In order for the authorization and liability protections to apply, veterinarians and veterinary students must be participating in association with a COVID vaccination effort by a state, local, tribal, or territorial authority, or by an institution in which the COVID vaccine is administered. Additional specific requirements also must be met, such as having basic certification in CPR, completing the CDC COVID vaccination modules, an observation period, etc. There is a separate section of the declaration that applies to those in the uniformed services and for federal employees, contractors and volunteers when authorized to administer COVID vaccine.

· While the liability outlined in the PREP Act is broad, it does not apply to willful misconduct, and the federal government does not provide a legal defense in the event that you are sued. Your state may have separate liability protections, along with separate requirements to qualify, and may or may not provide a legal defense. Veterinary malpractice will not likely respond to claims arising from a veterinarian intentionally vaccinating people against COVID.

More information on vaccination volunteer requirements

PREP Fact Sheet that Includes Veterinarians as Qualified Health Professionals

Federal Requirements for the Veterinarian-Client-Patient Relationship

The following guidance information has been provided by the AVMA

THE BASICS

The federal government regulates veterinary medicine and animal drugs very differently than it does human health care and drugs intended for human use. This is, in part, because veterinarians are key to maintaining a healthy, safe, and wholesome food supply and because they also play an important role in overseeing the judicious use of antimicrobials in animals. One important difference between human and veterinary medicine is that the U.S. Food and Drug Administration (FDA) has authority under the federal Food, Drug and Cosmetic Act (FDCA) over the use of animal drugs and human drugs by veterinarians, and the authority to define how a veterinarian-client-patient relationship (VCPR) is established for certain uses of animal and human drugs. [1]

For these uses, FDA has authority to require the keeping of veterinary medical records and to access them at any reasonable time to verify and copy them. [2] Use of animal and human drugs by veterinarians that violates the federal VCPR parameters set forth in the FDCA and its implementing regulations results in the drug being statutorily deemed unsafe for the use and, if in animal feed, the feed is statutorily deemed adulterated. [3] The USDA, which regulates veterinary biological products, also has promulgated rules defining a VCPR using the same language as the FDA. [4]

APPLICATION OF THE FEDERAL VCPR

The federal VCPR applies to any use of an FDA-approved human drug in animals, including over-the-counter (OTC) human drugs. [5] It applies to any use of an FDA-approved animal drug in any manner that differs from its approved labeling (Extra Label Drug Use [6]), such as a different frequency of administration, different dose, different medical indication for its use, different route of administration, or use in a different species. [7] It also applies to the use of compounded drugs by veterinarians [8] and a veterinarian’s authorization of a veterinary feed directive (VFD). [9] All of these are very common occurrences in the day-to-day practice of veterinary medicine.

Establishing the federal VCPR requires a physical examination of the animal or timely and medically appropriate visits to the premises where animals are kept. The FDA does not allow the VCPR to be established through electronic means. [10] FDA does allow the VCPR to be maintained electronically through telemedicine. [11] Veterinarians must comply with the federal VCPR in each of the circumstances in which it applies, irrespective of whether state law defines it differently.

The federal VCPR also applies in two important, but more limited, circumstances under USDA authorities. Veterinarians who manufacture biological products for use in their patients must do so within the context of the federal VCPR. [12] Veterinarians also must have established a federal VCPR when using prescription platform product biologics, which are a new category of biotechnology vaccines. [13]

CONFLICTING STATE AND FEDERAL VCPR DEFINITIONS AND TELEMEDICINE

• Conflicting state and federal VCPR definitions (e.g., states allowing the VCPR to be established electronically) would cause significant confusion. The FDA and USDA have used the same regulatory definition to avoid such confusion.
• Veterinarians must comply with the federal VCPR requirements where they apply, regardless whether state laws are more lax. Activities where the federal VCPR applies are extremely common in day-to-day veterinary practice.
• State law and regulations relating to the establishment of a VCPR that conflict with federal law would also cause telemedicine encounters to be frustrating for many veterinary clients. A veterinarian who has not already established a VCPR that complies with federal requirements (i.e., by conducting an in-person examination/visit) could not even recommend the use of an FDA-approved human OTC product for an animal without violating federal law.
• There are many valuable uses of telemedicine within the parameters of a federal VCPR.

21 USC 360b; 21 CFR Part 530
21 CFR 530.5
21 USC 360b(a)(1), (2), (4) & (5); 21 USC 342(a)
9 CFR 107.1(a)(1)
21 USC 360b(a)(5); 21 CFR 530.2; 21 CFR 530.3(a)
https://www.fda.gov/animal-veterinary/resources-you/ins-and-outs-extra-label-drug-use-animals-resource-veterinarians
21 USC 360b(a)(4); 21 CFR 530.2; 21 CFR 530.3(a)
https://www.fda.gov/animal-veterinary/resources-you/ins-and-outs-extra-label-drug-use-animals-resource-veterinarians#compounding; FDA Draft Guidance for Industry #256
21 CFR 558.6(b)
FDA letter to the American Veterinary Medical Association, April 6, 2017 – “Therefore, for the purposes of the federal definition, a VCPR cannot be established solely through telemedicine (e.g., photos, videos, or other electronic means that do not involve examination of the animal(s) or timely visits to the premises).”; During the pandemic FDA announced they will temporarily suspend enforcement of the federal VCPR physical exam and premises visit requirements. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/cvm-gfi-269-enforcement-policy-regarding-federal-vcpr-requirements-facilitate-veterinary. In this announcement FDA reiterated that under normal circumstances – “Given that the Federal VCPR definition requires animal examination and/or medically appropriate and timely visits to the premises where the animal(s) are kept, the Federal VCPR definition cannot be met solely through telemedicine.”
Id. “The regulations do not specifically address the use of telemedicine to maintain an established VCPR. However, based upon the language of the VCPR definition provided above, nothing would prohibit the use of telemedicine (e.g., use of photos, videos, or other electronic means that may be considered virtual) to allow the veterinarian to keep informed and able to make medical judgments regarding the health of the animal(s) and the need for medical treatment between periodic examinations of the animal(s) and/or timely visits to the premises where the animal(s) are being kept.”
9 CFR 107.1(a)
USDA Veterinary Services Memorandum 800.214