TABLE 3.
Scope of mandate requirements in centers implementing a vaccine mandate
| If your center has instituted a COVID−19 vaccine mandate AND a candidate has demonstrated an immediate allergic reaction to the vaccine or one of its essential components, what is your center’s practice regarding candidacy? (n = 42) | n (%) |
| Decline for active candidacy | 4 (9) |
| Exempt from the vaccine mandate | 26 (62) |
| Other | 12 (29) |
| If your center has instituted a COVID−19 vaccine mandate AND a candidate registers a religious objection to accepting the vaccine, what is your center’s practice regarding candidacy? (n = 42) | n (%) |
| Decline for active candidacy | 19 (45) |
| Exempt from the vaccine mandate | 7 (17) |
| Other | 16 (38) |
| Does your center’s COVID−19 vaccine mandate distinguish between the type of solid organ transplant? (n = 40) | n (%) |
| No: ALL actively listed solid organ transplant candidates at our center are subject to the vaccine mandate | 23 (57) |
| Yes: Only patients with non-life-threatening organ failure (e.g., renal failure requiring a kidney transplant) are subject to the vaccine mandate | 8 (20) |
| Yes: Only patients with life-threatening organ failure (e.g., decompensated cirrhosis, end-stage heart failure, end-stage lung disease) requiring a solid organ transplant are subject to the vaccine mandate | 0 (0) |
| Yes, other | 9 (22) |
| Does your center’s COVID−19 vaccine mandate distinguish between adult vs pediatric transplant candidates? (n = 41) | n (%) |
| No: The vaccine mandate applies equally to adult and all pediatric candidates (defined as age <18) | 4 (10) |
| No: The vaccine mandate applies to adult and pediatric candidates, but is limited to pediatric candidates for whom the COVID−19 vaccine is approved under EUA or full FDA approval | 5 (12) |
| Yes: The vaccine mandate applies to adult candidates, but pediatric candidates (defined as age<18) are excluded from the mandate | 11 (27) |
| N/A (Our center only performs transplants in adult candidates) | 16 (39) |
| Other | 5 (12) |
| If your center has instituted a COVID−19 vaccine mandate for (EUA-eligible) pediatric candidates, and the candidate’s parent and/or guardian refuses vaccination on behalf of the candidate, what is your center’s practice regarding candidacy? (n = 41) | n (%) |
| Decline active candidacy for transplants in all circumstances | 2 (5) |
| Waive the vaccine requirement in all circumstances | 2 (5) |
| Decline active candidacy if end-stage organ failure is life-threatening (e.g., decompensated cirrhosis) | 1 (2) |
| Decline active candidacy if end-stage organ failure is NOT life-threatening (e.g., kidney failure alone) | 5 (12) |
| N/A (Our center’s vaccine mandate does not include pediatric candidates OR our center does not transplant pediatric patients) | 27 (66) |
| Other | 4 (10) |
| If your center has instituted a COVID−19 vaccine mandate for adult or pediatric candidates, does your center require evidence of “vaccine responsiveness” as a condition of active candidacy? (n = 41) | n (%) |
| No: Documentation of COVID−19 vaccination is sufficient | 39 (95) |
| Yes: Vaccinated candidates must demonstrate spike-protein IgG titers above a designated threshold, or some other objectively defined measure of vaccine responsiveness | 1 (2) |
| Other | 1 (2) |
| If your center requires evidence of COVID−19 “vaccine responsiveness” as a condition of active candidacy, how does your center disposition a candidate who is “hypo-responsive”? (n = 39) | n (%) |
| N/A (documentation of COVID−19 vaccination alone is sufficient) | 38 (97) |
| Require serial vaccine (booster) doses in hypo-responsive candidates until sufficient responsiveness thresholds are achieved | 1 (3) |
| Other | 0 (0) |
| Does your center require solid organ transplant candidates to have a designated support person as a condition for receiving a transplant? (n = 40) | n (%) |
| Yes | 38 (95) |
| No | 1 (2) |
| Unsure | 1 (2) |
| If your center has instituted a COVID−19 vaccine mandate for adult or pediatric transplant candidates and ALSO requires candidates to have a designated support person, does your center also require the candidate’s support person to be vaccinated against COVID−19? (N = 40) | n (%) |
| Yes | 4 (10) |
| No | 30 (75) |
| N/A (Our center does not require a support person) | 3 (7) |
| Other (please specify) | 3 (7) |
| If your center has instituted a COVID−19 vaccine mandate for adult or pediatric transplant candidates, and your candidate regularly cohabitates with others (family or otherwise), does your center also require that the candidate’s cohabitants be vaccinated against COVID−19? (n = 40) | n (%) |
| Yes | 2 (5) |
| No | 36 (90) |
| Other (please specify) | 2 (5) |
| Does your center’s COVID−19 vaccine mandate distinguish candidates with a documented prior SARS-CoV−2 infection? (n = 40) | n (%) |
| No: The vaccine mandate applies to candidates regardless of prior SARS-CoV−2 infection status, and regardless of pre-vaccination spike-protein antibody titer or other markers or prior infection | 38 (95) |
| Yes: The vaccine mandate is not required for candidates with documented prior SARS-CoV−2 infection | 1 (2) |
| Yes: The vaccine mandate is not required for candidates with documented prior SARS-CoV−2 infection AND evidence of a threshold spike-protein antibody titer or another marker of prior infection | 1 (2) |
| Other | 0 (0) |