“These are extremely high risk patients,” he said. “These are patients who, if they contract COVID, are at high risk of serious illness and death. “
Bioethicists and doctors at UHN at the hospital’s Ajmera Transplant Center also took into account the limited supply of donor organs when creating the vaccination policy, Smith said. Currently, 796 patients are on UHN’s organ waiting lists.
“We have a loyalty and a responsibility to this very scarce resource,” Smith said. “We want the chances of success after the transplant to be the best in the world. “
So far, UHN is the only hospital in Ontario to force COVID vaccines on patients awaiting transplants, although other centers are considering the issue.
St. Joseph’s Healthcare Hamilton is reviewing its policies for patients awaiting kidney transplants and will share its decision in the coming days, Dr. Christine Ribic, medical director of the hospital transplant, said in an email to The Star .
“Our program consistently supports the recommendation of the COVID-19 vaccine before transplantation to reduce the increased risk of severe COVID post-transplant,” she said. “We balance this with the principle of equitable access to care for patients awaiting transplants. “
The Trillium Gift of Life Network, the provincial agency responsible for organ and tissue donation, has not mandated COVID vaccines for potential organ recipients. (TGLN transferred to Ontario Health on April 1, 2021.)
In a statement to the Star, Ontario Health (Trillium Gift of Life Network) said it was “in the process of developing a clinical guidance document in support of vaccination while recommending each transplant center proceed on a case-by-case basis, depending on the medical emergency and a risk assessment. to the patient. “
The statement said the agency recommends COVID vaccines for transplant recipients and highlights data showing the risk of death is “two to five times higher in transplant patients than in the general population” from COVID.
The statement also noted that transplant recipients must already take recommended medications, including vaccines, and that “donated organs are scarce and gifts are publicly entrusted.”
Smith said UHN’s vaccination policy for transplant recipients does not contradict current Ontario Health recommendations. However, he said, the agency expressed concern that a COVID vaccine policy could lead to fewer people consenting to be organ donors.
For UHN, Smith said the proven benefits of requiring COVID vaccination to protect vulnerable patients outweigh the theoretical risk of losing potential organ donors.
As the ethical debate over mandatory COVID vaccination is tense, Ontario has long had rules in place for transplant recipients to ensure organs are allocated to those who would benefit most, Alison said. Thompson, associate professor of bioethics at the University of Toronto.
“We treat donated organs as if they were precious resources because they are so scarce,” she said. “We are asking people to show that they will benefit from it, even if it means changing their behavior, so that they can maximize the benefit of this organ, of this donation. “
Megan Ogilvie is a Toronto-based health reporter for The Star. Follow her on Twitter: @megan_ogilvie