FAQ: COVID-19 Basics for Transplant Patients
Last updated July 16, 2021
If you or a loved one is a UCSF transplant patient, you can find answers here to questions about the coronavirus (COVID-19), vaccines for COVID-19 and how to otherwise minimize your risk of infection.
Is the COVID-19 vaccine safe?
We recommend the COVID vaccine for all pre- and post-transplant patients as well as all living donors. Early data shows that there may be decreased efficacy in immunosuppressed individuals. We expect more data about this over the weeks and months to come. Please remain cautious by wearing masks, washing your hands and practicing social distancing. You can find more information in this COVID-19 vaccine FAQ sheet from the American Society of Transplantation.
I am taking medications that suppress my immune system. Do I need to take special precautions with regard to COVID-19?
Based on experience with other viral respiratory infections, it is possible that COVID-19 infection will be more severe in the immunosuppressed population. Immunosuppressed patients should take the following precautions:
- Continue to wear a mask and practice social distancing in public, even after receiving the vaccine.
- Wash your hands often with soap and warm water, scrubbing for at least 20 seconds each time. When soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
- Practice normal infection prevention techniques, such as regular handwashing, covering your nose and mouth when coughing, and avoiding individuals who are sick.
Should I continue to take my immunosuppressive medications?
Yes. If you develop any signs of illness, such as fever or respiratory symptoms, contact your medical team for guidance on whether to continue these medications as well as whether to seek care. If you have any questions about your regimen, check with your doctor.
Are donated organs safe?
Yes, organ procurement organizations test all potential deceased donors for COVID-19 prior to offering the organs for transplant.
Is living organ donation safe during the pandemic?
All living donors are tested for COVID-19 the week prior to surgery and are advised to quarantine at home until they are admitted to the hospital for the procedure. All patients, including donors and recipients, are also tested at the time of admission.
Should living donors be vaccinated for COVID-19?
We recommend the COVID-19 vaccine for all living donors. They should receive it no less than 48 hours before surgery. This allows time to observe for any reaction.
National Kidney Registry donors should receive the vaccine at least seven days before surgery, so that entire chains aren't jeopardized and there's time to observe for any reaction.
As someone with immunosuppression, how do I talk with my employer about workplace accommodations?
These letters from UCSF Transplant Services may help you communicate with your employer about precautionary measures in the workplace that can help keep you and your family safe.
Where and when can I get a COVID-19 vaccine?
At this time, the vaccine is readily available through state vaccination sites as well as clinics and pharmacies. Contact your local pharmacy or make an appointment with a vaccine clinic near you at myturn.ca.gov.
Will the COVID vaccine hurt my transplanted organ?
As previously noted, the recommendation is to wait at least one month after your transplant surgery to receive either of the available COVID-19 vaccines. You can find more information in the American Society of Transplantation's COVID-19 vaccine FAQ sheet.
Is it OK to get the vaccine if I have another underlying condition, such as cancer or heart failure, or if I've had a multiorgan transplant?
Anyone with multiple or complex health conditions should consult their primary care provider about whether the vaccine is right for them.
What if I've had allergies to vaccines in the past?
If you've ever had an allergic reaction to a vaccine, please talk to your primary care provider about whether the vaccine is right for you. Also, the CDC offers an information page on allergic reactions to COVID and other vaccines.
Has anyone had life-threating reactions to the COVID-19 vaccines?
The CDC notes that there have been reports of severe reactions that required treatment with epinephrine or a trip to the hospital. If you have had a serious reaction to any of the ingredients in the currently available COVID-19 vaccines, the CDC recommends that you do not get one of these vaccines. Read more from the CDC about vaccine reactions.
What if I feel sick after receiving the vaccine?
You may be having a 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 from the vaccine?
No, do not premedicate. In general, taking over-the-counter medications – such as aspirin, acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) – before receiving a vaccine can blunt your immune system's response to the vaccine, reducing its efficacy. However, if you have symptoms that make you uncomfortable after your vaccination, you may take an over-the-counter pain reliever to help you feel better.
Should I receive two vaccine doses, and do they have to be the same brand?
The Pfizer and Moderna vaccines both require two doses, while the Johnson & Johnson vaccine requires only one.
Ideally, if you receive a vaccine that requires a second dose, the second dose should be the same brand. You must receive both doses to achieve optimal protection.
- The Pfizer vaccine doses are given 21 days apart.
- The Moderna vaccine doses are given 28 days apart.
Can I choose among Pfizer, Moderna and Johnson & Johnson?
We recommend that you receive whichever vaccine is available to you.
Should I continue to wear a mask after being vaccinated?
Yes. Your body's response to the vaccine takes time, early data shows that immunocompromised individuals may not respond as robustly to the vaccine as other people. You should therefore wear a mask and practice social distancing when outside of your household, even after receiving the vaccine.
I've received my organ transplant. Will the COVID-19 vaccines work for me?
Researchers are examining the immune response of organ transplant recipients to the vaccines, and so far, the evidence suggests it is not as strong as we would wish. Whereas the general population shows rates of seroconversion (producing specific antibodies in response) above 80 percent, one study of 658 vaccinated organ recipients found a seroconversion rate of 54 percent about four weeks after the second dose. Patients who had received certain kinds of medications, such as antimetabolites, were less likely to have an antibody response to their vaccination.
While you will likely have incomplete protection from COVID-19, we recommend that you receive the vaccine. Being fully vaccinated may still lower your risk of getting infected as well as your risk of becoming seriously ill if you do catch the virus. In addition, be sure to encourage your friends and family members to get vaccinated, and continue to exercise preventive measures, such as social distancing and masking, when around unvaccinated people or anyone whose vaccination status is unknown.
Should I get a blood test to measure my response to my COVID-19 vaccination?
The Food and Drug Administration does not recommend routinely checking antibody response after vaccination, particularly as it’s unclear what the 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 place to turn with specific questions is your own providers.
If I do get COVID-19, what should I know about therapy alternatives, such as monoclonal antibodies?
Currently, the evidence suggests that early administration of monoclonal antibodies for the COVID-19 virus may benefit patients who have an elevated risk of becoming seriously ill, reducing the likelihood of hospitalization and death.
The evidence for using convalescent plasma (donated by people who have recovered from COVID-19 infection) is less convincing. One small study showed benefit, but a more recent study showed no effect on survival. Theoretically, antibody-based therapies may help immunosuppressed transplant patients early in the course of illness from the coronavirus, but further data is needed to determine whether these treatments actually lead to better outcomes.
- COVID-19 Information From the Centers for Disease Control and Prevention
- COVID-19 FAQs From Transplant Candidates and Recipients (American Society of Transplantation)
- COVID-19 Vaccine FAQ Sheet (American Society of Transplantation)
- COVID-19 Resources for the Transplant Community (American Society of Transplantation)
- COVID-19 Transplant Resource (COVID-19 Transplant Community Coalition)
- SARS-CoV-2 Vaccination in Heart and Lung Transplantation (International Society for Heart and Lung Transplantation)
- COVID-19 Vacunas para Pacientes Hispanos y Transplantes (AST webinar, "COVID-19 Vaccines for Hispanic Transplant Patients with special guest, José Luis Rodríguez)
Webinars: Organ Transplants and Donation During COVID-19
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.