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COVID-19 vaccination for people post-transplant and on the waiting list

COVID-19 vaccines & PH In this section

The following information was published by NHS Blood and Transplant on 30th June 2021:

The NHS recommends that vaccination is the best protection for everyone from severe disease, risk of hospitalisation and death due to COVID-19.

Recipients of solid organ and islet transplants and patients listed for a transplant were not included in vaccination trials in the UK. As a result, there has been uncertainty about the level of protection from vaccination in these groups as compared to healthy volunteers and the general population. There was concern that the vaccine may not be as effective for patients classified as clinically extremely vulnerable from COVID-19 due to underlying health conditions and/or the need to take anti-rejection medication (immunosuppression).

Recently, data from Public Health England, which identifies patients testing positive for COVID-19, and the national vaccine registry were linked with the NHS Blood and Transplant (NHSBT) transplant registry.  The combined data was used to identify transplant recipients and patients on the transplant waiting list in England who have received one or two doses of the COVID-19 vaccine and who have subsequently tested COVID-19 positive. This is a practical way to look at the impact of vaccination and its ability to prevent the most severe forms of COVID-19.

Analysis performed by NHSBT shows that approximately 80% of transplant recipients and patients waiting for a transplant in England had received both doses of the vaccine by 24th June 2021. The uptake of COVID vaccination was lower in London (75%) and in people from Black, Asian, Mixed Race and Minority Ethnic backgrounds (65-75%).

Between 8th Dec 2020 – 24th of June 2021:

  • Of approximately 6700 transplant recipients who had not received even one vaccine dose, 7% (466) contracted COVID-19. Of these, 50% (236) died within 28 days of a positive COVID test.
  • Of approximately 39,000 transplant recipients who had received both vaccine doses, less than 1% (76) contracted COVID-19 two weeks or more after second vaccine dose. Of these 8% (6) died within 28 days of a positive COVID-19 test.
  • Of approximately 650 patients on the transplant waiting list who had not received even one vaccine dose, 8% (51) contracted COVID-19 two weeks or more after second vaccine dose. Of these 17% (8) died within 28 days of the positive test.
  • Of approximately 3100 patients on the transplant waiting list who received both vaccine doses, less than1% (5) contracted COVID-19 two weeks or more after the second vaccine dose and none died within 28 days of the positive test.

This data strongly supports the recommendation that, in the absence of any other health contraindication, suitable transplant recipients and patients on the transplant waiting list should accept the offer of two doses of the vaccine for maximum protection against contracting or dying from COVID-19. This analysis also confirms that amongst transplant recipients and patients waiting for a transplant, unvaccinated patients had a very high chance of dying if they contracted COVID-19.  

Studies will continue on how best to measure and improve the effectiveness of the response to COVID-19 vaccination in immunosuppressed or immunocompromised patients.  Transplant recipients and patients waiting for a transplant and their close contacts must continue to follow latest government advice, to reduce the risk of infection, even when vaccinated.