Updated December 15, 2022

This page provides answers to questions you may have about COVID-19 vaccines if you or a loved one is a UCSF transplant patient. For more information, including recommendations for immunosuppressed patients, please see our COVID-19 vaccine page.

I'm on the transplant waiting list. Should I get vaccinated?

Yes. As of July 1, 2022, UCSF requires all patients to be fully vaccinated against COVID-19 prior to solid organ transplant. At the time of transplant, patients are immunosuppressed, making their vaccine response less robust than it would have been previously. That's why you should get vaccinated now.

I'm a living donor. Should I get vaccinated?

We recommend COVID-19 vaccination for all living donors. National Kidney Registry donors should receive the vaccine at least seven days before surgery so that donor chains aren't jeopardized and there's time to monitor for reactions.

I received my organ transplant. Should I get vaccinated?

We recommend that you get the COVID-19 vaccine, including the boosters. The extra doses will improve your immune response and enhance your protection. We recommend the bivalent boosters (either Pfizer or Moderna); these more recent formulations work better against the Omicron variant than previous versions. Being fully vaccinated lowers your risk of getting infected as well as your risk of becoming seriously ill with COVID-19. In addition, encourage your friends and family members to get vaccinated, and continue to take preventive measures, such as social distancing and masking, particularly when around unvaccinated people or anyone whose vaccination status you don't know.

A member of my household is a transplant recipient. Should I get vaccinated?

We strongly encourage all eligible family and household members living with transplant recipients to remain up-to-date with COVID-19 vaccination, including booster doses. Transplant recipients are likely to have a diminished response to the vaccine, so they'll be better protected if all their close contacts are fully vaccinated.

Which vaccine should I get?

For your first two doses, we recommend that you get either of the mRNA vaccines (Pfizer or Moderna) or the Novavax COVID vaccine. You should then get a bivalent booster (either Pfizer or Moderna); these more recent boosters work better against the Omicron variant.

Where and when can I get a COVID-19 vaccine?

At this time, COVID-19 vaccines are readily available at UCSF, as well as through state vaccination sites as well as clinics and pharmacies. Visit our website, contact your local pharmacy or visit myturn.ca.gov to make an appointment with a vaccine clinic near you.

I received my organ transplant. How well will the COVID-19 vaccine protect me?

Researchers are examining the immune response of organ transplant recipients to the COVID-19 vaccines, and so far, the evidence suggests it's not as strong as we would wish. Whereas the general population shows rates of seroconversion (producing specific antibodies in response to the vaccine) above 80%, one study of 658 vaccinated organ recipients found a seroconversion rate of 54% about four weeks after the second dose. Patients who received certain kinds of medications, such as antimetabolites, were less likely than the general population to have an antibody response to vaccination. While you may have incomplete protection from COVID-19, being fully vaccinated may still lower your risk of getting infected as well as of becoming seriously ill if you do catch the virus.

I received my organ transplant. Should I get a blood test to measure my response to the COVID-19 vaccine?

The Food and Drug Administration (FDA) doesn't recommend routinely testing antibody response after vaccination, particularly since it's unclear what these results actually mean about how well an individual is protected. Doctors are working to translate relevant study findings into guidance for their patients, so the best source of answers to specific questions is your own provider.

Is the COVID-19 vaccine safe?

We believe the vaccine is safe for nearly everyone. We recommend COVID-19 vaccination for all pre- and post-transplant patients, living donors and close contacts.

Will the COVID vaccine hurt my transplanted organ?

No episodes of organ rejection have been definitively linked to COVID-19 vaccines so far. You can find more information in the American Society of Transplantation's COVID-19 vaccine FAQ sheet. For most patients, the benefits of COVID-19 vaccination greatly outweigh the risk of these rare events. And the risk of life-threatening complications from COVID far exceeds the risk from vaccination. There have been very rare reports of severe reactions that required treatment with epinephrine or a trip to the hospital. If you previously had a serious reaction to any ingredient in the currently available COVID-19 vaccines, the Centers for Disease Control and Prevention (CDC) recommends not receiving that vaccine. Read more from the CDC about vaccine reactions.

What if I feel sick after receiving the vaccine?

You may be having a reaction or response to the vaccine. Consult your primary care provider right away for guidance, including on whether to seek treatment. The CDC's information page on vaccine reactions offers additional information.

Should I take anything before the shot to prevent side effects?

No, you shouldn't premedicate. However, if you have symptoms that make you uncomfortable after your vaccination, you may take an over-the-counter pain reliever. Please only use over-the-counter medications that are recommended by your transplant team.

I'm taking medications that suppress my immune system. Do I need to take special precautions with regard to COVID-19?

Immunosuppressed people are at risk for more severe sickness from COVID-19 and prolonged recovery. Immunosuppressed patients should take the following precautions:

  • Continue to wear a mask and practice physical distancing when you're indoors or in crowded public areas, even after you're vaccinated.
  • Wash your hands often with soap and warm water, scrubbing for at least 20 seconds each time. When soap and water aren't available, use a hand sanitizer that's at least 60% alcohol.
  • In addition to regular hand-washing, practice the usual infection-prevention techniques, such as covering your nose and mouth when coughing and avoiding people who are sick.

You can find more information in the American Society of Transplantation's COVID-19 vaccine FAQ sheet.

What is Evusheld (tixagevimab and cilgavimab)?

Evusheld is an investigational drug that can help prevent COVID-19 infection. It's a monoclonal antibody treatment (not a vaccine) that provides antibodies to the COVID-19 virus for up to six months. Evusheld is administered as two injections into the buttocks during one appointment.

Evusheld can protect patients who meet the following criteria:

  • Immunocompromised
  • Over 18 years old
  • No active COVID-19 infection or symptoms
  • No recent close contact with a person known to be infected with COVID-19

Evusheld should be administered at least two weeks after the most recent COVID-19 vaccine dose. This medication doesn't take the place of vaccination, and we recommend all patients stay up-to-date on their COVID-19 vaccination.

With changing viral variants, it's possible that Evusheld may become less effective over time. UCSF Health continues to monitor the data and will stop offering the medication if it's no longer thought to have value.

As an investigational medication, Evusheld may have the following risks:

  • Bleeding. Some people with low platelet levels shouldn't receive an injection into a muscle due to an increased risk of bleeding.
  • Heart problems. In rare cases, heart attacks and other cardiac events have occurred. These are most common in patients with known cardiovascular risks or a history of heart problems.

Contact your primary or specialty care doctor or your UCSF transplant coordinator to learn whether Evusheld is available and right for you. At UCSF, we offer Evusheld to all transplant patients whose doctors recommend it.

For more information, explore UCSF's guidance on COVID-19 medications and the Food and Drug Administration's Evusheld fact sheet.

If I do get COVID-19, should I continue to take my immunosuppressive medications?

Yes. But immediately upon developing any sign of illness, such as fever or respiratory symptoms, contact your medical team for guidance on whether you should continue these medications and whether you should seek care. If you have any questions about your regimen, check with your doctor.

If I do get COVID-19, what should I know about treatments, such as antiviral medications and monoclonal antibodies?

Currently, evidence suggests that these treatments may reduce the likelihood of hospitalization and death for patients with an increased risk of becoming seriously ill. However, they must be administered soon after the onset of symptoms – within five days for oral antiviral medications and 10 days for some monoclonal antibodies – so it's important to contact your transplant care provider as soon as possible to expedite your therapy. Also, please discuss safety issues with your transplant care provider before taking these medications as there can be interactions with some immunosuppressants.

For more information, visit our COVID-19 vaccine information and COVID-19 resources for patients pages.

Are donated organs safe?

Yes. Organ procurement organizations test all potential deceased donors for COVID-19 before offering their organs for transplant.

Is living organ donation safe during the pandemic?

All living donors are tested for COVID-19 the week before their surgery and are advised to quarantine at home until they're admitted to the hospital for the procedure. All patients, including donors and recipients, are also tested at admission.

As someone who is immunosuppressed, how do I talk with my employer about workplace accommodations?

These letters from UCSF's transplant services may help you communicate with your employer about precautionary measures in the workplace that can help keep you and your family safe.