Right now, more than 106,600 people in the U.S. are on the national transplant waiting list, each hoping to hear soon that a lung, kidney, heart, or other vital organ has been found for them. It’s the promise not just of a new organ, but a new life.
Well before they are placed on that list, transplant candidates, as they’re known, are evaluated with a battery of tests and exams to be sure they are infection-free, their other organs are healthy, and that all their vaccinations are up to date.
Now, COVID vaccinations — and some people’s resistance to them — have turned what used to be routine preparation controversial.
In January, a 31-year-old Boston father of two declined to get the COVID-19 vaccine, and Brigham and Women’s Hospital officials removed him from the heart transplant waiting list. And in North Carolina, a 38-year-old man in need of a kidney transplant says he, too, was denied the organ when he declined to get the vaccination.
Those are just two of the most recent cases. The decisions by the transplant centers to remove the candidates from the waitlist have set off a national debate among ethicists, family members, doctors, patients, and others.
On social media and in conversation, the question persists: Is removing them from the list unfair and cruel, or simply business as usual to keep the patient as healthy as possible and the transplant as successful as possible?
Two recent tweets sum up the debate.
“The people responsible for this should be charged with attempted homicide,” one Twitter user said, while another suggested that the more accurate way to headline the news about a transplant candidate refusing the COVID-19 vaccine would be: “Patient voluntarily forfeits donor organ.”
Doctors and ethics experts, as well as other patients on the waiting list, say it’s simply good medicine to require the COVID vaccine, along with a host of other pre-transplant requirements.
“Transplant medicine has always been a strong promoter of vaccination,” says Silas Prescod Norman, MD, a clinical associate professor of nephrology and internal medicine at the University of Michigan, Ann Arbor. He is a kidney specialist, or nephrologist, who works in the university’s transplant clinic.
Requiring the COVID vaccine is in line with requirements to get numerous other vaccines, he says.
“Promoting the COVID vaccine among our transplant candidates and recipients is just an extension of our usual practice.”
“In transplantation, first and foremost is patient safety,” Norman says. “And we know that solid organ transplant patients are at substantially higher risk of contracting COVID than non-transplant patients.”