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Cleveland Clinic and UH requiring transplant patients to be vaccinated

Cleveland Clinic
Posted at 12:20 PM, Oct 08, 2021
and last updated 2021-10-08 19:13:40-04

CLEVELAND — Cleveland Clinic patients on the transplant list or individuals who are a living donor are now required to be vaccinated against COVID-19, the hospital announced on Friday.

Reporter Jade Jarvis is working to learn more - watch News 5 this evening for her full report.

The Cleveland Clinic said the requirement was put in place to protect patient safety regarding solid organ transplantation.

"For the transplant candidate, in addition to a major operation, medications taken after an organ transplant weaken a person’s immune response," the hospital said.

It's important for transplant patients to have the vaccine due to their weakened immune systems since "their body has a reduced ability to fight and recover from infections," according to the Cleveland Clinic.

As far as living donors go, the hospital said it's crucial that COVID-19 infection is prevented around the time surgery takes place.

"The FDA-authorized vaccines have been determined to be safe and effective and are the best way to prevent severe illness and death from COVID-19," the Cleveland Clinic said.

News 5 spoke with a woman scheduled for a kidney transplant at Cleveland Clinic in the next two weeks. She reached out to News 5 with concerns about the policy.

She didn’t want to be identified out of fear of jeopardizing the procedure, but she said she’s not vaccinated for both medical and religious reasons. Her spouse is her donor. She said she received a letter Monday informing her about the new rules, weeks after she made the appointment for the surgery. She said when she made the appointment, staff members did not mention a vaccination requirement.

"I was confused. I was devastated because I didn't know what they were going to require of us. So I immediately picked up the phone. And I've been calling every day since that day multiple times a day, and I've received multiple different answers," she said.

The woman said no one she's spoken to about Cleveland Clinic has been able to give her a clear answer about whether she will have to adhere to the policy.

One day they're saying, 'Well, because Nov. 1 is the deadline to get the vaccine, but because your date is before then you're not going to have to get it.' And then the next day they'll say, ‘Well, we're not 100% sure, we don't know. You might need to get the vaccine or they're going to cancel the surgery,’” the woman said. “And then the next day, it's, 'Well, your surgery is before that, so you don't have to get it. And then the next day, it's like, 'You definitely have to go get it, go get it right now.' And with our work schedules and everything, we can't do that. We're already prepping to take a lot of time off."

She plans to ask questions and make her case in person at a pre-op appointment next week.

As for the legality of vaccine mandates for transplant patients, experts say hospitals can impose medical requirements before certain procedures.

"I believe it's perfectly legal," Sharona Hoffman, a professor of law and bioethics at Case Western Reserve University School of Law, said. "If they think that vaccination is necessary because they need to make as sure as possible that you are not infected at the time of the donation and when you are dealing with so many other health care providers and patients around, I think they are certainly empowered to have that requirement."

She also spoke about the ethics of vaccine mandates in hospitals.

"I believe a vaccine is to patient's benefit. And so they are inducing patients to do something that will protect them, that is for their own health. And so I don't see an ethical problem. If a patient really doesn't want to get vaccinated, they can seek care elsewhere, though with a transplant that is far more complicated. Of course, if there's a medical reason for them not to be vaccinated, the hospital has to take that into account," Hoffman said.

Cleveland Clinic FAQs about the new policy

When does Cleveland Clinic's vaccination policy for organ transplant donors/recipients go into effect?

"The vaccination is to prevent severe illness or death from COVID-19. To date, we have not removed anyone from the transplant waiting list because they were not vaccinated.

Patients currently on the waiting list have until November 1st to meet the Cleveland Clinic COVID-19 safety protocol for organ transplantation from a deceased donor. If patients waiting for an organ from a deceased donor are not vaccinated after 11/1, they will be made inactive on the UNOS waiting list.

For organ transplantation using a living donor, which involves the living donor undergoing a scheduled surgery, we are requiring COVID-19 vaccination for both donor and recipient before we can proceed with the surgery, for the safety of both."

Are there medical and/or religious exemptions for patients regarding the vaccine? 

"There are possible medical exceptions but it would be very rare and reviewed on a case by case by a multidisciplinary team of experts.

As part of the transplant evaluation process, candidates must be evaluated by a multidisciplinary healthcare team to determine if transplantation is appropriate. The evaluation includes a review of the patient’s medical, surgical, and psycho-social history, and a variety of tests. Many factors are considered as part of the evaluation."

Will Cleveland Clinic cancel surgeries and/or remove patients from the transplant waiting list if they're unvaccinated? 

"The vaccination is to prevent severe illness or death from COVID-19. To date, we have not removed anyone from the transplant waiting list because they were not vaccinated.

Patients currently on the waiting list have until November 1st to meet the Cleveland Clinic COVID-19 safety protocol for organ transplantation from a deceased donor. If patients waiting for an organ from a deceased donor are not vaccinated after 11/1, they will be made inactive on the UNOS waiting list.

For organ transplantation using a living donor, which involves the living donor undergoing a scheduled surgery, we are requiring COVID-19 vaccination for both donor and recipient before we can proceed with the surgery, for the safety of both."

Other hospitals doing the same
The University Hospitals Transplant Institute said it will soon require its transplant patients to be vaccinated as well.

The hospital issued the following statement regarding the matter:

"The health and safety of our patients is a top priority for us at University Hospitals. In light of recent studies pointing to the risk solid organ recipients and living donors face if they contract COVID-19, the UH Transplant Institute will begin requiring COVID vaccinations for its patient population. We are following policies in this area already put into place at several other Ohio and national systems, and recommended by national transplant associations. Vaccination is particularly important in these patients for their safety. Transplant recipients are required to take medications to prevent organ rejection which weakens the immune system. For living donors, prevention of COVID around the time of surgery is essential. The COVID-19 vaccines are safe and effective, and the best way to prevent severe illness and death from COVID-19."

UH didn't say when the requirement will go into effect.

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