COVID-19 vaccination refusal and access to transplantation: an ethical conundrum. A legal analysis and a qualitative study with key stakeholders

Background: Infection with COVID-19 is associated with a substantial mortality rate among solid organ transplant recipients and is also associated with high morbidity. Effective vaccines against COVID-19 infections are now available. However, the drugs necessary to avoid graft rejection reduce the effectiveness of COVID-19 vaccines. Given the stronger effects of vaccines pre-transplant, many transplant programs are struggling with the issue of whether or not vaccines should be mandated before listing for a transplant. Medical utility, beneficence and scarcity of organs are arguments supporting vaccine mandate. On the other hand, fairness, non-maleficence and autonomy are ethical arguments against vaccine mandate. Objective: To perform a legal analysis of the vaccine mandate and to gather key stakeholders’ perspectives on the ethical issues related to the vaccine mandate and access to transplantation in
order to inform future Canadian guidelines on this topic. Methods: We will conduct a legal analysis of the vaccine mandate and access to medical care
and transplantation. We will also conduct interviews with transplant recipients and candidates, parents of pediatric recipients and candidates and transplant professionals from both adult and pediatric Canadian transplant programs. Anticipated outcomes: The results will inform future discussions on vaccine mandates in transplantation in Canada.

FORTIN, Marie-Chantal

Centre Hospitalier de l'Universite de Montreal

James Kreppner Award Program

Quebec

$49,952