Corrections & Clarifications: This story was updated Oct. 20 to correct the name of UCHealth, a nonprofit health care system based in Colorado. This does not affect the rating for this item.
The claim: Colorado hospital system is requiring COVID-19 vaccine for transplant patients
As vaccine mandates spur debate and anger in workplaces across the country, some on social media claim vaccines are also being cited to deny organ transplants to some patients.
"Unvaccinated organ transplant patients in Colorado removed from waitlist," reads a graphic shared in an Oct. 6 Instagram post.
The post, citing another Instagram post and the New York Post, claims the policy is being enforced by UCHealth, a large, nonprofit health care system based in Colorado, on all its patients and their live donors.
The post garnered over 5,000 likes on Instagram, according to CrowdTangle, a social media insights tool.
In an email to USA TODAY, UCHealth spokesperson Kelly Tracer confirmed that "in almost all situations, transplant recipients and living donors," within the health system "are now required to be vaccinated against COVID-19 in addition to meeting other health requirements."
UCHealth declined to discuss particular patients because of federal privacy laws related to patient care.
But that's not quite the whole story. Immunization requirements for transplant patients are not a new policy, experts say. And UCHealth is not alone in its COVID-19 vaccine mandate: health systems nationwide are requiring or recommending the shots to ensure transplant patients – an already vulnerable group – don't die from the virus.
USA TODAY reached out to the Instagram users for comment.
COVID-19 infection puts transplant patients at risk of death
Patients undergoing an organ transplant must meet certain requirements to protect them before and after surgery, said Tracer and Dr. Deepali Kumar, president-elect of the American Society of Transplantation.
People on waitlists typically already are vaccinated to protect against infectious hepatitis A and B, pneumonia, shingles and the flu, Kumar told USA TODAY.
"Patients may also be required to avoid alcohol, stop smoking, or prove they will be able to continue taking their anti-rejection medications long after their transplant surgery," Tracer said. "These requirements increase the likelihood that a transplant will be successful and the patient will avoid rejection."
Preventing organ rejection generally requires taking immunosuppressive drugs, which work to quiet down the transplant recipient's immune system so it won't reject the new organ. But this silencing also leaves patients significantly more vulnerable to COVID-19 infection and death than the general population.
A December 2020 study from France of more than 1,000 people hospitalized with COVID-19 found 18% of kidney transplant patients died, compared with 11% of nontransplant COVID-19 patients. In other studies looking not only at kidney transplant patients but other organs as well, this rate was between 20% and 30%.
Experts say it's important to be vaccinated before a transplant because the vaccine is less effective if administered after a transplant due to anti-rejection medications.
A lower percentage of post-transplant patients develop a "demonstrable antibody response" from the vaccine compared with the general population, Dr. David Klassen, chief medical officer of the United Network for Organ Sharing, a nonprofit that manages the nation's transplant waiting list, told USA TODAY.
"It's quite clear, they do not have the same response," he said. "That's one reason transplant patients were singled out early on for booster shots and being eligible for a third dose of Pfizer vaccine."
Hospitals nationwide requiring or recommending COVID-19 shot before transplant
UCHealth is not the only health system imposing a COVID-19 vaccine mandate for its transplant patients.
Cleveland Clinic recently announced it would also require the shot for both transplant recipients and living donors, the Associated Press reported. Existing patients need to be vaccinated before Nov. 1 or risk being placed on the inactive list.
University Hospitals of Ohio has also issued a COVID-19 vaccine requirement for its patients and their living donors, NBC News reported.
Hospital systems like the University of San Franciso Health, the University of Alabama at Birmingham Medicine, Virginia Commonwealth University Health and Massachusetts General Hospital in Boston are strongly recommending live donors and transplant patients get vaccinated before surgery.
"There's no reason to be shocked, surprised or outraged about COVID vaccine," Art Caplan, head of the division of medical ethics at NYU Grossman School of Medicine, told USA TODAY. "It's just adding to a list of prudent and required vaccines to prevent the death of an immunosuppressed person after transplant."
Our rating: Missing context
Based on our research, we rate MISSING CONTEXT the claim a Colorado hospital system is requiring COVID-19 vaccine for its unvaccinated transplant patients. UCHealth confirmed it is requiring unvaccinated transplant patients and their living donors to get vaccinated against the virus. But hospitals have long-imposed requirements for vaccinations and other lifestyle limitations for transplant patients to give them the best chance at a successful operation and survival. Studies have shown transplant recipients are at a high risk of dying from COVID-19 compared to infected nontransplant patients. And several other hospitals systems are also requiring or strongly recommending patients and their living donors get vaccinated.
Our fact-check sources:
Kelly Tracer, Oct. 7, Email exchange to USA TODAY
American Journal of Transplantation, Dec. 1, 2020, Is COVID-19 infection more severe in kidney transplant recipients?
American Journal of Transplantation, Dec. 16, 2020, An early experience on the effect of solid organ transplant status on hospitalized COVID-19 patients
Associated Press, Oct. 8, Colorado woman who won't get vaccinated denied transplant
UCSF Health, Oct. 7, FAQ: COVID-19 Basics for Transplant Patients
The University of Alabama at Birmingham Medicine, accessed Oct. 8, Organ Transplant Patients & the COVID-19 Vaccine: Frequently Asked Questions
Virginia Commonwealth University Health, Aug. 25, COVID-19 vaccines and transplant patients: Third dose recommended
Massachusetts General Hospital, July 12, COVID-19 Vaccine Guidance for Patients with Organ Transplants
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This article originally appeared on USA TODAY: Fact check: Hospital requiring COVID-19 shot for transplant patients