Table 1: Summary of ethical arguments.

Table 1 briefly summarizes the arguments in support of denying solid organ transplantation on the basis of vaccine refusal, and the arguments in opposition.

Is it Appropriate to Deny Solid Organ Transplantation on the Basis of Vaccine Refusal?
Arguments in Support	Arguments in Opposition
Beneficence: Benefits the patient by protecting the patient and their graft from complications of vaccine-preventable illness.	Non-maleficence: Inability to access a transplant causes immediate, severe, and irreversible harm to patients who refuse vaccination.
Beneficence: Maximally protects others in the clinical environment, including transplant patients, other patients, and healthcare staff. Avoids negative impact on performance metrics and transplant center liability.	Autonomy: Achieving vaccination through coercion risks damaging the provider-patient relationship, the family unit and the public perception of vaccination.
Stewardship: Maximizes the benefits of organ transplantation, a scarce resource.	Justice: Creates additional barriers to transplantation for patients from marginalized groups.
Justice: Is consistent with OPTN recommendations that “serious, consistent, and documented non-compliance” be considered in listing decisions.	Respect: Relies on unproven assumptions about adherence to other recommendations apart from vaccination, and fails to respect patients’ reporting of their intentions.

Abbreviations: OPTN, Organ Procurement and Transplantation Network.