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Survey of Current Transplant Center Practices Regarding Covid-19 Vaccine Mandates in the United States

B. E. Hippen1, D. Axelrod2, K. Maher3, R. Xi3, D. Kumar4, M. Schnitzler3, K. Lentine3

1Head of Transplant Medicine, Fresenius Medical Care, Charlotte, NC, 2University of Iowa Transplant Clinic, Iowa City, IA, 3St. Louis University School of Medicine, St. Louis, MO, 4Ajmera Transplant Centre, Toronto, ON, Canada

Meeting: 2022 American Transplant Congress

Abstract number: 261

Keywords: COVID-19, Ethics, Public policy, Vaccination

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

Session Information

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

Session Type: Rapid Fire Oral Abstract

Date: Monday, June 6, 2022

Session Time: 3:30pm-5:00pm

 Presentation Time: 3:30pm-3:40pm

Location: Hynes Room 311

*Purpose: We surveyed current policies of transplant centers regarding a COVID-19 vaccine mandate, and rationales for or against a mandate policy.

*Methods: An electronic survey was distributed to clinicians at U.S. solid organ transplant programs from 2020-2021.

*Results: 56.4% of transplant programs representing 78.5% of all kidney transplant volume and 82.4% of liver transplant volume in the US from 9/1/20-9/1/21 responded to the survey. 35.7% of centers reported implementing a vaccine mandate, while 60.7% reported not that vaccination was not required and 3.6% were uncertain. Centers without a vaccine mandate policy cited administrative, equity, and legal considerations (Figure A). Centers with a vaccine mandate cited clinical evidence supporting the efficacy of pre-transplant vaccination (82.0%) and stewardship obligations to ensure organs were transplanted into the lowest risk patients (64.0%) (Figure B).

Among centers with a mandate, few required confirmation of vaccine responsiveness through antibody testing (2.6%), required a support person (10.0%) or co-habitants (5.0%) to be vaccinated. 42.5% of centers with a mandate also required living donor candidates to be vaccinated. There was no correlation between the presence or absence of a vaccine mandate and the point prevalence rate of COVID-19 vaccination by the home State of the transplant center.

*Conclusions: Solid organ transplant centers in the US exhibit significant heterogeneity in the requirement for a COVID-19 vaccination prior to receiving an organ. While all centers encourage vaccination, most programs do not require all candidates and living donors to receive the COVID-19 vaccine prior to surgery, citing administrative opposition, legal prohibitions, and concern about equity in access to transplants. Among the minority of centers mandating COVID-19 vaccination for candidates, few centers also mandate vaccination for support persons or co-habitants, require additional testing to demonstrate adequate vaccine responsiveness, and less than half of these centers also mandate vaccination for living donor candidates.

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To cite this abstract in AMA style:

Hippen BE, Axelrod D, Maher K, Xi R, Kumar D, Schnitzler M, Lentine K. Survey of Current Transplant Center Practices Regarding Covid-19 Vaccine Mandates in the United States [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/survey-of-current-transplant-center-practices-regarding-covid-19-vaccine-mandates-in-the-united-states/. Accessed May 9, 2025.

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