*Purpose: An effective and widely-accepted SARS-CoV-2 vaccine could protect the community and vulnerable populations. We investigated the attitudes of solid organ transplant recipients (SOTRs) towards a SARS-CoV-2 vaccine and identified potential barriers to vaccination.

*Methods: We conducted a national survey of SOTRs between November 11 – December 2, 2020 through the network and social media platforms of the National Kidney Foundation. We studied 3 major domains: a) attitudes towards a vaccine, b) impact of the pandemic on daily life, and c) impact on mental health.

*Results: Among 1308 SOTRs, 783 (59.9%) were female and 1035 (79.1%) were White. Respondents were evenly distributed throughout the US and were largely college graduates (829, 63.4%) and married (830, 63.5%). Half (647, 49.5%) of SOTRs would be either unsure or unwilling to receive a SARS-CoV-2 vaccine once available (Table 1). Major concerns included side effects (537, 85.2%), lack of rigor in vaccine development (439, 69.7%), and incompatibility with organ transplant (482, 75.4%). However, 1135 (86.8%) SOTRs would be willing to receive a vaccine if recommended by a transplant provider. A small fraction (161, 12.3%) were in self-isolation and severe anxiety related to the COVID-19 pandemic remained low (25, 1.9%). There were no significant differences in vaccine attitudes after the announcement of 94.5% efficacy in the mRNA-1273 vaccine (Moderna, Inc.).

*Conclusions: Transplant recipients expressed large amounts of skepticism in a potential SARS-CoV-2 vaccine, even after announcements of high vaccine efficacy. However, transplant providers may be the defining influence in vaccine acceptance due to the trust vested in them.

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