Open AccessKidney transplantation and patients who decline SARS‐CoV‐2 vaccination: an ethical framework
Author(s) -
Gökmen Refik,
Cronin Antonia,
Brown Wendy,
Cass Stephen,
Ghazanfar Abbas,
Hossain Mohammad Ayaz,
Johnson Jenny,
Longdon Trish,
Lyon Sue,
McLean Adam,
Motallebzadeh Reza,
Popoola Joyce,
Samuel Ayo,
Thuraisingham Raj,
Wood AngelaJane,
Dor Frank J. M. F.
Publication year - 2021
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13979
Subject(s) - medicine , listing (finance) , vaccination , united network for organ sharing , transplantation , kidney transplantation , family medicine , kidney transplant , intensive care medicine , immunology , liver transplantation , finance , economics
Summary As SARS‐CoV‐2 vaccines have started to be rolled out, a key question facing transplant units has been whether listing for transplantation should be contingent on recipients having received a vaccine. We aimed to provide an ethical framework when considering potential transplant candidates who decline vaccination. We convened a working group comprising transplant professionals, lay members and patients and undertook a literature review and consensus process. This group's work was also informed by discussions in two hospital clinical ethics committees. We have reviewed arguments for and against mandating vaccination prior to listing for kidney transplantation and considered some practical difficulties which may be associated with a policy of mandated vaccination. Rather than requiring that all patients must receive the SARS‐CoV‐2 vaccine prior to transplant listing, we recommend considering vaccination status as one of a number of SARS‐CoV‐2‐related risk factors in relation to transplant listing. Transplant units should engage in individualised risk–benefit discussions with patients, avoid the language of mandated treatments and strongly encourage uptake of the vaccine in all patient groups, using tailor‐made educational initiatives.