The policy drew attention this week after a Colorado Springs woman had her spot on a kidney transplant list “inactivated,” with the threat of removal from the list entirely, if she doesn’t pursue COVID vaccination within 30 days.
The woman, Leilani Lutali, told KOAA News she harbors reservations about the shot. Her living donor, Jaimee Fougner, says she objects for religious reasons.
UCHealth says its policy protects the lives of everyone involved. The network has cited studies showing that unvaccinated transplant recipients who contract COVID-19 are much more likely to die from the disease than the broader population.
Organ recipients must take anti-rejection drugs that suppress their immune systems, leaving them much more vulnerable to infection. Between 20% and 30% of unvaccinated transplant recipients who contract COVID-19 have died, the hospital said, compared to a 1.6% mortality rate for everyone else.
On Tuesday, Colorado state Rep. Tim Geitner (R) shared a letter on social media that Lutali received from University of Colorado Hospital’s transplant center informing her of the decision:
UCHealth defended the policy in a statement Wednesday, noting that transplant recipients must adhere to a number of other requirements in addition to COVID vaccination, all of which exist “to ensure patients have the best chances of recovery and good outcomes.”
Prospective organ recipients must also be vaccinated against other viruses, for instance, and must avoid alcohol, stop smoking and demonstrate an ability to take anti-rejection medications long-term.
If a patient is unwilling or unable to take those steps, physicians may advise against the operation. Given the extremely limited availability of organs suitable for transplant, the argument goes, they should be allocated to patients where the procedure is most likely to succeed.
Is this ethically justifiable?
Dr. Olivia Kates, an assistant professor of medicine at Johns Hopkins University who specializes in infectious diseases in transplant patients and studies the ethics of vaccination, says yes.
Transplant programs have a responsibility to protect organ recipients, and vaccination is a safe, easy and effective means of doing so, Kates told HuffPost in an email. That obligation extends to living donors, and to the health care workers and other patients in the transplant center.
“Vaccine mandates are really not about punishing non-vaccination, but promoting vaccination and ensuring that people who are not vaccinated are not made even more vulnerable to COVID-19 through transplantation and immunosuppression,” Kates said.
“I think the term mandate itself is interesting,” she went on. “Mandate refers not only to a rule or requirement but also to a calling or duty. I believe we all have a mandate ― a calling ― to be vaccinated ourselves and promote vaccination in others, for the good of our communities.”
Kates noted that transplant patients with COVID-19 may potentially be a source for emerging variants of concern, making vaccinations within the group all the more important.
UCHealth spokesperson Dan Weaver told HuffPost that other transplant centers have similar policies, and that many are expanding them to include COVID vaccines. The hospital network includes 12 acute-care full-service hospitals, and more than 150 clinics across Colorado, southern Wyoming and western Nebraska.
Lutali told 9News she’s now looking for a hospital out of state that’s willing to perform the operation.