The case against COVID-19 vaccine mandates in pediatric solid organ transplantation.
Pediatr Transplant
; 26(7): e14243, 2022 11.
Article
in English
| MEDLINE | ID: covidwho-1685411
ABSTRACT
BACKGROUND:
The American Society of Transplantation in conjunction with the International Society for Heart and Lung Transplantation released a joint statement on August 13, 2021 in which they strongly recommend that solid organ transplant (SOT) recipients and their eligible household members and close contacts be vaccinated against SARS-CoV-2 with an approved COVID-19 vaccine. Some SOT programs have gone further and will refuse to list or transplant candidates unless the candidate and their household are vaccinated against SARS-CoV-2.METHODS:
Two general pediatrician-ethicists use current best evidence and moral theory to argue why it is unethical to mandate COVID-19 vaccination for pediatric SOT candidates, their primary support person, and their households.RESULTS:
Pediatric vaccine mandates are most justifiable when they prevent the harm of a serious vaccine preventable disease (VPD) in children in settings where transmission is highly likely and there are no alternatives that are effective in preventing transmission that intrude less on individual freedom. An additional justification for a vaccine mandate in the SOT context is stewardship of a scarce resource if there is significant risk of graft loss from the VPD to an unvaccinated SOT candidate or recipient. Current evidence does not support fulfillment of these criteria in pediatric solid organ transplantation.CONCLUSIONS:
Making SOT listing contingent on COVID-19 vaccination is problematic. Though there is some risk of harm to a pediatric SOT candidate in remaining unvaccinated, the risk of harm of not being listed and transplanted is greater and overriding.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vaccines
/
Organ Transplantation
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Topics:
Vaccines
Limits:
Child
/
Humans
Language:
English
Journal:
Pediatr Transplant
Journal subject:
Pediatrics
/
Transplantation
Year:
2022
Document Type:
Article
Affiliation country:
Petr.14243
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