Recipients of solid organ and islet transplants and patients listed for a transplant were not included in vaccination trials in the UK. As a result, there has been uncertainty about the level of protection from vaccination in these groups as compared to healthy volunteers and the general population. There was concern that the vaccine may not be as effective for patients classified as clinically extremely vulnerable from COVID-19 due to underlying health conditions and/or the need to take anti-rejection medication (immunosuppression).
Recently, data from Public Health England, which identifies patients testing positive for COVID-19, and the national vaccine registry were linked with the NHS Blood and Transplant (NHSBT) transplant registry. The combined data was used to identify transplant recipients and patients on the transplant waiting list in England who have received one or two doses of the COVID-19 vaccine and who have subsequently tested COVID-19 positive. This is a practical way to look at the impact of vaccination and its ability to prevent the most severe forms of COVID-19.
Analysis performed by NHSBT shows that approximately 80% of transplant recipients and patients waiting for a transplant in England had received both doses of the vaccine by 24th June 2021. The uptake of COVID vaccination was lower in London (75%) and in people from Black, Asian, Mixed Race and Minority Ethnic backgrounds (65-75%).
The data strongly supports the recommendation that, in the absence of any other health contraindication, suitable transplant recipients and patients on the transplant waiting list should accept the offer of two doses of the vaccine for maximum protection against contracting or dying from COVID-19. This analysis also confirms that amongst transplant recipients and patients waiting for a transplant, unvaccinated patients had a very high chance of dying if they contracted COVID-19.
Studies are recommending that those on the transplant list and therefore not taking immunosuppresssant drugs should take up the vaccines as soon as offered as their levels of anti-bodies will come close to those in the general population.
Studies will continue on how best to measure and improve the effectiveness of the response to COVID-19 vaccination in immunosuppressed or immunocompromised patients. Transplant recipients and patients waiting for a transplant and their close contacts must continue to follow latest government advice, to reduce the risk of infection, even when vaccinated.