Loyola Medicine experts have concluded that COVID-19 vaccine requirements for lung transplant patients are an ethical and necessary practice. Daniel Dilling, MD, medical director of the lung transplantation program at Loyola Medicine, and Mark Kuczewski, Ph.D., a professor of medical ethics at the Stritch School of Medicine, shared their recommendation in a paper published by the Journal of Heart and Lung Transplant.
They concluded, “The politicization of our current public health crisis has rendered controversial many simple measures to address the spread and effects of COVID-19…We believe that requiring vaccination against COVID-19 should not be controversial when we focus strictly on established frameworks and practices surrounding eligibility for wait-listing to receive a solid organ transplant.”
“Transplant patients are at a much higher risk for contracting severe cases of COVID-19 due to the medication required after transplant that suppresses their immune system,” said Dr. Dilling. “Getting the vaccine before being immunosuppressed ahead of a transplant provides a much better level of protection than if patients wait to be vaccinated afterward.”
Dr. Dilling partnered with Dr. Kuczewski and other members of the bioethics department at Loyola Medicine to study COVID-19 vaccine requirements for transplant patients. “The ethical framework that has evolved over the decades indicates that physicians have an obligation to both the patient in need of a transplant and the donor. As stewards of the gift the donor is giving to the recipient, the transplant team must give that gift a reasonable chance to flourish,” said Dr. Kuczewski.
Transplant patients have historically been required to stop smoking and taking narcotics, modify alcohol intake and receive flu or hepatitis vaccines before they are placed on the waiting list. Dr. Dilling and Dr. Kuczewski concluded that a COVID-19 vaccine requirement reasonably aligned with these prerequisites. They also concluded that a COVID-19 vaccine requirement for immediate family members and caretakers in close contact with a transplant patient would be an ethical practice.
After concluding their discussions, Dr. Dilling and Dr. Kuczewski submitted their paper in hopes that it would provide a road map for other transplant programs as they navigate discussions on how to ethically justify a COVID-19 vaccine requirement.
Loyola Medicine’s lung transplant program has a COVID-19 requirement in place for their patients. “Our primary concern is the safety and well-being of the patient before us and honoring the stewardship of the donor,” said Dr. Dilling.
Dr. Dilling’s message to transplant patients who might be feeling vaccine hesitance is that COVID-19 vaccines are safe and effective. “The likelihood of having a serious adverse reaction to the vaccine is so low compared to the risk of getting COVID-19 if you aren’t vaccinated,” he said. “And the risk of contracting a severe case of COVID-19 goes way up after having a lung transplant.”
