When freshman Aidan Fishkind was preparing to come to Elon from Michigan, they had planned to get their monthly allergy shots through Student Health Services. Since health services’ only registered nurse retired over the summer, Fishkind said they will be at least six weeks behind by the time they get their next shot. 

“Right now is when I need them — fall — because the leaves are just about to start falling,” Fishkind said. “Pollen’s about to increase. I'm going to  have no protection.”

At the end of the 2022-23 academic year, Registered Nurse Cynthia Moore retired after working at Elon for over 14 years. Registered nurses are licensed through the North Carolina Board of Nursing and, according to the NCBON, their role within a medical practice includes the implementation and evaluation of patient care. The NCBON was unavailable for comment.

The lack of registered nurses on its staff affects what treatments health services are able to administer in patient care. Elon Student Health Services currently has two physician assistants, two primary care nurse practitioners and three certified medical assistants on staff. 

Elon’s interim Nursing Program Director Stacey Thomas wrote in an email to Elon News Network that while being a registered nurse requires a two year associate degree in nursing, passing a national certification exam and state licensure, certified medical assistants are only required to have a high school diploma and successfully complete a medical assisting program. Medical assistants are also not regulated by the NCBON.

“Medical assistants don’t need to be certified and are basically office assistants with a little bit of medical training added in,” Thomas wrote.

Fishkind said when they originally called in July, health services told them Moore had retired, but had someone to administer treatment.

Fishkind said when they called again before moving on campus Aug. 10, they were informed health services no longer had a staff person who could give allergen immunotherapy shots.

“I hadn't called to check in again because I had no reason to believe that there's going to be any issues,” Fishkind said. “Then I called again, just to be like, ‘Hey, just making sure everything's good’ and they’re like ‘No, everything fell apart.’”

Fishkind said their original injection appointment was scheduled for Sept. 7, but now the earliest they can get their treatment is Oct. 20. Fishkind said, with their treatment plan, they are supposed to get the shots every four weeks. 

Since Fishkind can no longer get their shots through health services, they had to look outside of Elon to find a clinic that would continue their treatment.

“The people at health services have so far been really considerate and they've helped me figure out where to go,” Fishkind said. “They gave a ton of names and they were super apologetic and they were just very helpful.”

Fishkind said they called the allergists health services recommended but found some of them would not continue a treatment plan from another practice. If they went to one of these centers, Fishkind said they would have to restart their treatment plan completely. 

“I'm not about to start from point one. I can't go back three times a week. I physically cannot get there that many times between how expensive it would be with the transportation and with Ubers and stuff,” Fishkind said. “At one point, the only option was going all the way to Greensboro.”

There are only three locations in a 25 mile radius from campus that can administer allergy shots, according to a directory by the American Academy of Allergy, Asthma and Immunology. LeBauer Allergy and Asthma has two locations, one in Burlington and the other in Greensboro. Allergy and Asthma Center of North Carolina also has a Greensboro location. 

Fishkind said they started looking for alternatives as soon as they learned they could not get their allergy shots through health services, but Fishkind said they first found out in August. 

“At that point, … we were way too late,” Fishkind said.

Fishkind said they were eventually able to schedule a consultation appointment at LeBauer Allergy and Asthma for Oct. 19 — 42 days after they were originally supposed to get the injection. 

Fishkind said they have been calling LeBauer regularly to see if there are any cancellations but so far has not been able to move the appointment to a closer date. 

Allergy shots are a form of long-term treatment to decrease sensitivity to allergens. The shots work similarly to a vaccine, according to AAAAI.

“Your body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen,” AAAAI’s website states.

Nationwide, nearly one third of U.S. adults and more than a quarter of U.S. children report having seasonal allergies, eczema or food allergies, according to the Centers for Disease Control and Prevention. Though a considerable portion of the U.S. has allergies, Fishkind’s struggle to find an allergist is not unique. According to the American College of Asthma, Allergy and Immunology, a medical organization made up of allergist-immunologists and other medical professionals, there is an ongoing shortage of certified allergists in the U.S. 

According to the ACAAI, allergy shots are given in an allergist’s office due to the potential risk of anaphylaxis shortly after the injection. 

Thomas said the risk of allergy shots causing anaphylactic shock, a life-threatening allergic reaction, is why CMAs are unable to administer the shots themselves. 

“CMAs are not trained or equipped to handle life threatening emergencies such as that. Registered nurses are,” Thomas said. “If a CMA works in an allergy clinic and has been trained to administer the shots and is being supervised by a RN, MD, PA, or NP and has emergency equipment on standby, then and only then they may be able to administer the shots.”

While Fishkind said none of their allergens are severe enough to cause anaphylaxis on their own, there is still a risk of anaphylactic shock when receiving the shots. 

Fishkind has said they have already started noticing a significant impact from being off of their treatment schedule. They said they have had to leave classes several times due to their symptoms and have struggled with navigating Elon’s campus due to exposure to their environmental allergens. 

“My allergies definitely have been picking up,” Fishkind said. “Usually in the mornings I'm fine, then this morning I was up for five minutes and I had to get Benadryl because I was already like a six out of 10 with my symptoms — which is, you know, real pain.”

In addition to worrying about the medical aspects of their shots being postponed, Fishkind said the unexpected financial burden of switching from health services is also taking a toll. 

“I don't really know how bad this is gonna push me back,” Fishkind said. “Aside from the medical parts of any withdrawal stuff, or whatever, the financial part of this is big too and the buses don't go there so I have no public transport to take either.”

Fishkind said they do not have a car on campus and had not been expected to pay regular Uber fees in addition to paying for their appointments and medication. 

According to the Uber app, it would cost around $14 for Fishkind to travel to and from LeBauer’s Burlington location each month once they begin receiving treatment there. 

Fishkind also said that getting their treatment will now be a larger time commitment then they were originally planning on with the added travel time, making it more difficult to receive their treatment between their class schedule and extracurriculars. 

Fishkind said health services told them they are working to find a new nurse who can give the treatments. Fishkind said they are planning to switch to health services as soon as it’s possible. 

Student Health Services did not respond to requests for comment.

LeBauer Allergy and Asthma declined Elon News Network’s request for comment.