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International Practices on COVID-19 Vaccine Mandates for Transplant Candidates

Y. Caliskan1, B. E. Hippen2, D. Axelrod3, M. Schnitzler1, K. Maher1, T. Alhamad4, S. Anwar5, V. Kute6, K. Lentine1

1Saint Louis University, Saint Louis, MO, 2Transplant Medicine, Fresenius Medical Care, Charlotte, NC, 3University of Iowa, Iowa City, IA, 4Washington University School of Medicine at St. Louis, Saint Louis, MO, 5Sheikh Shakhbout Medical Hospital, Abu Dhabi, United Arab Emirates, 6Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, India

Meeting: 2022 American Transplant Congress

Abstract number: 1327

Keywords: Infection, Patient education, Vaccination, Waiting lists

Topic: Clinical Science » Public Policy » 21 - Non-Organ Specific: Public Policy & Allocation

Session Information

Session Name: Non-Organ Specific: Public Policy & Allocation

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented challenges and there are practice differences for solid organ transplant programs worldwide. We sought to assess an international perspective on COVID-19 vaccine mandates and rationales for or against a mandate policy.

*Methods: We administered an electronic survey instrument to staff at transplant programs outside the United States (October-November 2021) that comprised of 23 questions addressing the reasons cited by centers for or against implementing a vaccine mandate. Each responding transplant program was represented once in the analysis.

*Results: Respondents (n=63) represented 19 countries on 5 continents. More than half (52.6%) of centers reported implementing a vaccine mandate, however 37.2% reported that their center has not considered (27.1%) or unsure (10.2%) on vaccination requirement. The main rationale for centers not implementing a vaccine mandate were concerns for undue pressure to transplant candidates, equity and legal considerations. (Fig. 1) The main rationale for centers with a vaccine mandate were efficacy of pre-transplant vaccination then post-transplant, importance for public health and minimizing exposure of other patients. (Fig. 2) The majority (79%) of the centers mandate vaccine regardless of prior SARS-CoV-2 infection status, and regardless of pre-vaccination spike-protein antibody titer or other markers or prior infection. Only 24.4% of centers with a vaccine mandate for transplant candidates also extended a vaccine requirement to potential living donors.

*Conclusions: The approach to pre-transplant COVID-19 vaccination mandate is heterogeneous across different countries and centers. More than one third of centers are reluctant to consider vaccine mandates for a varies of reasons including ethical, legal and equity concerns.

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To cite this abstract in AMA style:

Caliskan Y, Hippen BE, Axelrod D, Schnitzler M, Maher K, Alhamad T, Anwar S, Kute V, Lentine K. International Practices on COVID-19 Vaccine Mandates for Transplant Candidates [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/international-practices-on-covid-19-vaccine-mandates-for-transplant-candidates/. Accessed May 9, 2025.

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