ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2021
The limits of refusal: An ethical review of solid organ transplantation and vaccine hesitancy.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed.
- Canadian Transplant Candidates' and Recipients' Perspectives on Mandatory Vaccination and Access to Transplantation: A Qualitative Study.Clinical transplantation · 2026Article
- Impact of COVID-19 vaccination on long-Term patient and kidney allograft survival following SARS-CoV-2 infection.medRxiv : the preprint server for health sciences · 2026Article
- Review
- Role of Complement-dependent Cytotoxicity Crossmatch and HLA Typing in Solid Organ Transplant.Reviews on recent clinical trials · 2024Review
- Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.Pediatric transplantation · 2023Article
- Refusal of transplant organs for non-medical reasons including COVID-19 status.Clinical ethics · 2023Article
- Coronavirus Disease-2019 and Implications on the Liver.Clinics in liver disease · 2023Review
- Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey.Frontiers in transplantation · 2023Article
- The case against COVID-19 vaccine mandates in pediatric solid organ transplantation.Pediatric transplantation · 2022Article
- Considering a COVID-19 vaccine mandate for pediatric kidney transplant candidates.Pediatric nephrology (Berlin, Germany) · 2022Review
- Caregiver COVID-19 vaccination for solid organ transplant candidates.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- Executive orders prohibiting vaccine mandates: Implications for transplant patients and physicians.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- The Global Impact of COVID-19 on Solid Organ Transplantation: Two Years Into a Pandemic.Transplantation · 2022Review
- Survey of current transplant center practices regarding COVID-19 vaccine mandates in the United States.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- Ethical review of COVID-19 vaccination requirements for transplant center staff and patients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- Mandating COVID-19 vaccination prior to kidney transplantation in the United States: No solutions, only decisions.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- COVID-19 Vaccination and Remdesivir are Associated With Protection From New or Increased Levels of Donor-Specific Antibodies Among Kidney Transplant Recipients Hospitalized With COVID-19.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- The impact of COVID-19 on kidney transplant care.Frontiers in medicine · 2022Review
- COVID-19 Spurs Transplant Vaccination Policy.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients With CKD.Kidney international reports · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
Patients pursuing solid organ transplantation are encouraged to receive many vaccines on an accelerated timeline. Vaccination prior to transplantation offers the best chance of developing immunity and may expand the pool of donor organs that candidates can accept without needing posttransplant therapy. Furthermore, transplant recipients are at greater risk for acquiring vaccine-preventable illnesses or succumbing to severe sequelae of such illnesses. However, a rising rate of vaccine refusal has challenged transplant centers to address the phenomenon of vaccine hesitancy. Transplant centers may need to consider adopting a policy of denial of solid organ transplantation on the basis of vaccine refusal for non-medical reasons (i.e., philosophical or religious objections or personal beliefs that vaccines are unnecessary or unsafe). Arguments supporting such a policy are motivated by utility, stewardship, and beneficence. Arguments opposing such a policy emphasize justice and respect for persons, and seek to avoid worsening inequities or medical coercion. This paper examines these arguments and situates them within the special cases of pediatric transplantation, emergent transplantation, and living donation. Ultimately, a uniform national policy addressing vaccine refusal among transplant candidates is needed to resolve this ethical dilemma and establish a consistent, fair, and standard approach to vaccine refusal in transplantation.
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