*Purpose: Promoting widespread COVID-19 vaccinations is a crucial strategy to protect living organ donors and transplant recipients during the pandemic. We examined perspectives and sources of hesitancy about COVID-19 vaccines among former and prospective living organ donors.

*Methods: We conducted an IRB-approved study of US living organ donors and prospective donors. An online survey was disseminated on multiple social media platforms between 12/28/20-2/9/21. Survey items included multiple choice, ranking, and ratings of agreement to statements about COVID-19 vaccine effectiveness, convenience, and importance. We used descriptive statistics and a multivariable logistic regression model to examine associations between respondent characteristics and preferences and COVID-19 vaccine acceptance.

*Results: Among 323 respondents from 40 US states and DC, 53% were 31-50 years old, 91% were non-Hispanic white, and 88% were female. Respondents included 267 living donors (94% kidney) and 56 in evaluation to donate (75% kidney). When asked if they would accept a COVID-19 vaccine, 76% answered yes, 11% no, and 13% unsure. Compared to those who would decline a vaccine or are unsure, respondents who would accept a vaccine were more likely to receive yearly influenza vaccines (48% vs 83%, p<0.001) and rely on public health officials for information (4% vs 35%, p<0.001). Respondents who relied on information sources other than public health officials were less likely to agree that COVID-19 vaccines are safe, effective, adequately studied or that donors and recipients should receive COVID-19 vaccines (Figure). Adjusting for demographics, education, and donor type, prioritization of public health officials for information and acceptance of yearly influenza vaccines were independently associated with higher COVID-19 vaccine acceptance (p<0.001 for both). The association between public health official guidance and higher COVID-19 acceptance was similar among respondents who do and do not receive yearly influenza vaccines (adjusted marginal probabilities of vaccine acceptance of 97% and 94%, respectively).

*Conclusions: Living organ donors who prioritize information from public health officials are more likely to accept a COVID-19 vaccine than those who rely on other information sources. Transplant programs could incorporate public health messaging and education when discussing the risks and benefits of COVID-19 vaccination.

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