Executive orders prohibiting vaccine mandates: implications for transplant patients and physicians.
Giuliano Testa, M.D.
Testa, G., Wall, A., Lee, S. H. and Fine, R. (2022). “Executive orders prohibiting vaccine mandates: implications for transplant patients and physicians.” Am J Transplant.
There is ongoing discussion within the transplant community, lay press and US government leaders about the appropriateness for vaccine mandates for transplant patients. In Texas, transplant centers are faced with the reality of having an executive order widely interpreted by hospitals administrations as prohibiting vaccine mandates in the provision of medical care.1 This policy is based on the laudable goal of providing all citizens access to life-saving medical care without discrimination based on their personal choices or personal responsibility for their medical problems. However, applying the executive order to ignore vaccination status to patients awaiting an organ transplant submits patients to a perfectly avoidable risk and puts transplant programs in a difficult predicament. The efficacy of the vaccine is inferior when it is given after the transplant and the severity of illness and mortality due to COVID -19 infection are significantly higher in unvaccinated transplant recipients.2-3 This translates into a higher risk of graft loss and patient death following transplantation which leads to a negative impact on outcomes for transplant programs that cannot consider vaccination status as part of their evaluation for listing or transplantation.