Congress Considers Bill to Outlaw Denial of Transplants to Unvaccinated

The U.S. House of Representatives is considering legislation that would make it unlawful for health care providers to deny organ transplants to patients who have declined to get COVID-19 shots.

H.R. 6534, the Stop Arduous Vaccine Enforcement (SAVE) Act of 2022, would amend the Public Health Service Act to prohibit transplant centers from denying organs to patients based on whether they have received a COVID-19 shot, including treating individuals as ineligible or lowering their priority on the transplant list.

The bill was introduced by Rep. Ben Cline (R-VA), and co-sponsors Reps. Rodney Davis (R-IL), Jeff Duncan (R-SC), Bob Good (R-VA), Morgan Griffith (R-VA), Chip Roy (R-TX), and Rob Wittman (R-VA), and referred to the House Committee on Energy and Commerce, on February 1.

‘Denied an Organ Transplant’

The SAVE Act is a response to reports of unvaccinated Americans being removed from the organ transplant list, says Cline.

“It is unimaginable that organ transplant centers would deny American citizens life-saving medical procedures solely for being unvaccinated against COVID-19,” said Cline, in a press release on the bill. “The SAVE Act ensures that no one is denied an organ transplant or donation based on their vaccination status.

“Getting vaccinated is a personal choice and should not be mandated,” said Cline “This legislation is not anti-vaccine, it’s about making sure individuals get the treatment they need.”

Patient Denied Transplant

In a widely reported case, a Boston man was refused a place on the heart transplant list at Brigham and Women’s Hospital because of his vaccination status.

The transplant center acted ethically and was not discriminatory, states an article titled “Should Patients Who Refuse COVID Vaccination Be Denied Transplantation Eligibility?” by academics at New York University and George Washington University published in the Journal of Cardiac Failure on February 8.

The authors state that organ transplant centers already require that candidates receive other vaccines and demonstrate a commitment against unhealthy activities such as drinking, smoking, or using illegal drugs. The article also states that the patient was given a left ventricular assist device instead of a donor’s heart.

Who Is Fully Vaccinated?

Refusing transplants to individuals who decline COVID-19 shots isn’t based on medical research, says Jane Orient, M.D., a policy advisor to The Heartland Institute, which co-publishes Health Care News, and executive director of the Association of American Physicians and Surgeons, which endorsed the SAVE Act.

“What would be needed is a study of transplant outcomes in vaccinated versus unvaccinated—likely impossible to do,” said Orient. “There are also no studies on desperately sick people, who would have been excluded from [vaccine] clinical trials. Immunosuppressed people, as all recipients will be, probably won’t respond.”

Furthermore, vaccination requirements change as the recommendations change, says Orient.

“So maybe they’ll require ‘full vaccination’ sometime before surgery,” said Orient. “But the vaccines apparently expire, so what good would a booster be? As for donors, the vaccine doesn’t prevent transmission, so what you want is an uninfected donor—you need to test [for virus infection], whether the donor is vaccinated or not.”

Potential for Harm

COVID-19 shots could be harmful to a patient undergoing organ transplant, says Orient.

“Does the vaccine damage the organ?” said Orient. “There is reason to think it might, say by microthrombi. There are few and highly inadequate studies of vaccine-damaged patients—especially autopsies on patients who died post-vaccination.”

For example, Simone Scott, a 19-year-old Northwestern University student, died in June after receiving a heart transplant and one month after receiving her second dose of the Moderna vaccine. In the Boston case, the heart patient had been diagnosed with atrial fibrillation and was concerned about the possible medical side effects from the vaccine.

Requiring vaccines for organ transplants is a medical/scientific issue rather than a question of the legality of discrimination, says Orient.

“It certainly violates the Oath of Hippocrates to give a patient any treatment more likely to harm than benefit,” said Orient.

Better Before Transplant

There is a rationale for requiring vaccinations for transplant patients, says Jeff Singer, M.D., a surgeon and senior fellow at the Cato Institute.

“Organ transplant recipients will need to be on immunosuppressants, in order to prevent rejection of the transplanted organ,” said Singer. “If they get infected by the COVID-19 virus after the transplant while they are immunosuppressed, they are at significantly greater risk of having a bad outcome—perhaps a fatal outcome—because they are unable to mount a strong immune response to the virus.”

It makes sense for patients to be fully immunized before a transplant, says Singer.

“There is a lot of evidence that suggests the vaccine is much less effective if taken after the transplant, when the immunosuppressants that transplant recipients must take suppress a good immune response to the vaccine—in fact, many immunologists think that it is people on immunosuppressants who might need a fourth or even more vaccination to get a decent response,” said Singer.