Update on Covid-19 vaccination in transplant patients and patients waiting for a liver transplant.

Posted on: 30th June 2021

Data from the NHS Blood and Transplant (NHSBT) registry has today (30th June 2021) shed new light on how effective vaccines are at protecting transplant patients, and those on the waiting list, from COVID-19.

Background

Recipients of solid organ 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 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.

What has the research found?

Between 8th Dec 2020 and 24th of June 2021:

  • Of approximately 39,000 transplant recipients who had received both vaccine doses, less than 1% (76) contracted COVID-19 two weeks or more after second vaccine dose. Of these 8% (6) died within 28 days of a positive COVID-19 test.
  • Of approximately 3,100 patients on the transplant waiting list who received both vaccine doses, less than 1% (5) contracted COVID-19 two weeks or more after the second vaccine dose and none died within 28 days of the positive test.
  • Of approximately 6,700 transplant recipients who had not received even one vaccine dose, 7% (466) contracted COVID-19. Of these, 50% (236) died within 28 days of a positive COVID test.
  • Of approximately 650 patients on the transplant waiting list who had not received even one vaccine dose, 8% (51) contracted COVID-19. Of these 17% (8) died within 28 days of the positive test.

What does this mean?

This data strongly supports the recommendation that, wherever possible, transplant recipients and patients on the transplant waiting list should have 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 will continue on how best to measure and improve the effectiveness of the response to COVID-19 vaccination in immunosuppressed or immunocompromised patients.

If you are a transplant recipient or you’re waiting for a transplant, please continue to follow latest government advice, to reduce the risk of infection, even when vaccinated.

More information

For more advice and information you might also like to visit these websites:

https://www.odt.nhs.uk/covid-19-advice-for-clinicians/  and  https://bts.org.uk/information-resources/covid-19-information/.