Updated July 7, 2022

If you or a loved one is a UCSF transplant patient, you can find answers here to questions about COVID-19 vaccines. For more information, including recommendations for immunosuppressed patients, see our COVID-19 vaccine page.

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

Yes, it is strongly recommended all patients on the transplant list be fully vaccinated prior to transplantation. Once a person is immunosuppressed at the time of transplant, response to a vaccine will be less robust than before.

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

We strongly encourage that all eligible family and household members living with transplant recipients be vaccinated, including booster doses. Transplant recipients are likely to have a suboptimal response to the vaccine, so the best way for all close contacts to protect them is to be fully vaccinated.

How much does the additional dose cost?

The vaccine is provided free to all patients.

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, all living donors, and all close contacts. While early data shows vaccination may be less protective for immunosuppressed individuals, we expect more data on that in the weeks and months to come. Please remain cautious by wearing a mask, washing your hands and practicing social distancing. You can find more information in a COVID-19 vaccine FAQ sheet from the American Society of Transplantation.

What is Evusheld (tixagevimab and cilgavimab)?

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

Evusheld can provide protection for patients who meet the following criteria:

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

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

  • Bleeding. Some people with very low platelet levels should not receive an injection into a muscle due to the 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 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, Evusheld supply is limited, but the medication is available to transplant patients who have a high risk of contracting COVID-19 or of experiencing complications as a result of the illness.

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

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's likely that COVID-19 infection will be more severe in immunosuppressed people. 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.
  • In addition to regular hand-washing, practice normal infection-prevention techniques, such as covering your nose and mouth when coughing and avoiding people 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 before offering the organs for transplant.

Is living organ donation safe during the pandemic?

All living donors are tested for COVID-19 the week before 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 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 monitor for any reaction.

National Kidney Registry donors should receive the vaccine at least seven days before surgery, so that entire donor chains aren't jeopardized and there's time to monitor for any reaction.

As someone with immunosuppression, 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.

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?

It's recommended to wait at least one month after your transplant surgery to be vaccinated, preferably with either the Pfizer or Moderna mRNA vaccine. 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?

People 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 very rare reports of severe reactions that required treatment with epinephrine or a trip to the hospital. For most patients, the benefit of COVID-19 vaccination greatly outweighs the risk of these rare events. And the risk of life-threatening complications from COVID far exceeds any risk from vaccination. 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 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 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 effectiveness. 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. As always, please only take over-the-counter medications that are recommended by your transplant team.

Can I choose among Pfizer, Moderna and Johnson & Johnson?

We recommend that you get one of the mRNA vaccines: Pfizer or Moderna.

Should I continue to wear a mask after being vaccinated?

Yes. Your body's response to the vaccine takes time to develop, and early data shows that immunocompromised individuals may not respond as robustly to the vaccine as other people. You should wear a mask and practice social distancing when outside 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's 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 than the general population to have an antibody response to their vaccination.

While you will likely have incomplete protection from COVID-19, we recommend that you get 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, particularly 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 FDA does not recommend routinely testing for antibody response after vaccination, particularly since it's unclear what such results actually show 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.

If I do get COVID-19, what should I know about therapy alternatives, such as monoclonal antibodies?

Currently, evidence suggests that if administered soon after onset of symptoms – within 5 days for oral antiviral medications or 10 days for some monoclonal antibodies – such treatment may benefit patients who have an elevated risk of becoming seriously ill, reducing the likelihood of hospitalization and death. Anti-viral medications that can be taken by mouth have recently become available as well. Please check with your transplant care provider before taking these medications as there can be interactions with some immunosuppression medication.

For more information, visit our COVID-19 Vaccine Information Hub and COVID-19 Resources for UCSF Patients pages.