Yes, You Can Be Denied A Transplant If You’re Not Vaccinated (and that’s not new)

Living with a chronic condition during a pandemic is… interesting. In many ways, the stakes are higher and more risky. In others, it’s a chance to see how the general public would react if they were put in our shoes. I’ll be honest, lots of y’all couldn’t deal. There is no greater example of this than the internet outrage surrounding the stories about hospitals requiring the Covid vaccine for transplants.

6 years ago today I was laying in the hospital mostly unconscious after discovering the “flu” I had been experiencing for two weeks was actually kidney failure. You can read the extended cut of that story here. To summarize, I went into kidney failure at 27, was on dialysis for about 18ish months, and got a transplant in the summer of 2017. To say I understand the nuances of the organ transplant process is to put it mildly. So, when this transplant/vaccine story started making the rounds, it understandably pushed some of my buttons.

In case you missed it (since it wasn’t the only kidney transplant story taking social media by storm), hospitals are now requiring organ recipients to receive the Covid-19 vaccine before approving them for transplant. This was accompanied by a viral social media post from a Colorado State Legislator of a letter someone received telling them they were being deactivated on the list for not having the vaccine.

I have some thoughts, preceded by a long, loud string of expletives.

First: Get the vaccine. Get the vaccine if you’re a “healthy” individual, but especially get the vaccine if you have kidney issues. Covid has a habit of attacking the kidneys and sending people, even “healthy” ones, into kidney failure. I can say from experience that I do not recommend. If you’re unsure or hesitant, go to YOUR doctor who has YOUR medical records and talk to them about your concerns. If you trust them enough to care for you when you’re sick you can trust them enough on vaccine information.

If you can’t afford to see a doctor, go get the vaccine. It’s free and a hell of a lot cheaper than the quarter to half million dollars two years of dialysis and a transplant costs.

If you’re getting your medical advice from randos on the internet… well I’m a rando on the internet and I say to get vaccinated. Not only do I have science on my side, I also have a very cute cat which means I am probably right.

One very cute cat. Photo by Matthew Trask

Second: I want to explain what this letter is and what it actually means, because this sort of letter is not rare among transplant patients and the Covid vaccine is the easiest thing on the list to fix.

When you need an organ transplant of any kind, you are registered with United Network for Organ Sharing (UNOS) to be put on the transplant list. To quote directly from their website:

[UNOS’s] policies and computerized network match donated organs with transplant candidates in ways that save as many lives as possible and provide transplant recipients with the best possible chance of long-term survival.

What this means is that there is a number of criteria that need to be met to receive an organ. For things like hearts and lungs, the threshold is lower because there is no way to survive without functioning hearts and lungs. With kidneys though, we have dialysis which can keep you alive for a number of years with no kidney function. This means the criteria to get a transplanted kidney is stricter. Some of these criteria include things you have no control over; age, reason for kidney failure, blood type, etc. Other things you might have control over, like weight/BMI or lifestyle habits like smoking. If you’re over a certain weight or you smoke, you gotta change that before you get listed.

You can also be denied listing if you don’t have an acceptable financial or social support system, which if there was a point in the process to get heated about inequity this would be it.

You also have to go get every single check up from every single specialist. For me, this meant the dentist, OBGYN, endocrinologist, and a bunch of cardio appointments. I also had to get boosters of every single vaccine I have ever known… from flu to hepatitis to shingles and more. You don’t get to decide to not get something done if you don’t want it… if your doctor thinks it’s an issue that can’t wait, then that’s what has to be done before you’re listed.

Which brings me to the crux of the previously shared letter: Medical Compliance.

All of the medical workups before your transplant are for two reasons:

  1. To make sure you’re healthy enough to have a successful transplant
  2. To make sure you’re in a position to maintain the success of your transplant

Getting a new organ isn’t like popping a new printer cartridge in and continuing on as before. It doesn’t magically resolve once the staples are pulled and the stitches heal. There’s maintenance involved. Doctors appointments. Medications. A compromised immune system. Buying Lysol wipes in bulk regardless of the pandemic status.

The cold hard truth is there aren’t enough organs for everyone – they’re gonna give it to the person who is the most likely to have a long successful life with that organ. If you’re not going to take a prescribed vaccine, how do they know you’re going to take your medication or show up to your appointments for the rest of your life? If you are not going to follow your doctor’s guidelines on your health, they are not going to give you the organ. In the case of kidneys, you can remain on dialysis as an alternative.

Another important thing to note is that this individual didn’t get “removed” from the list, they were deactivated. That means they’re still on the list, but greyed out so to speak. Should they get their required vaccinations, they would resume their place in the spot they would have been if they had been active all along. This is also not unusual. Sometimes something happens, like some wonky blood work or a suspicious mass on a CAT scan, and they deactivate you to make sure that there isn’t something else going on. Once you’re cleared, you’re back in your spot.

All of this to say that this is really a nothingburger of an issue to get worked up over. You’re trusting your doctor to either perform Frankenstein-like procedures on your body or to keep you alive with machines that filter your blood and literally drain your life force; but a vaccine is too far? That’s your prerogative but every choice has consequences that are attached. Choose wisely.

One thought on “Yes, You Can Be Denied A Transplant If You’re Not Vaccinated (and that’s not new)”

  1. Incidentally there was a great debate about this on the lung transplant forum of which I am a member. I am a lung transplant recipient. The members are mainly from the U.S. It was about carers getting the vaccine. Some said it was not a requirement. Others swore it was. Some transplant patients had said they did not get the vaccine and had discussed it with their doctors beforehand. It is a very hot topic at the moment.

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