Living Organ Donor Perspectives and Sources of Hesitancy about COVID-19 Vaccines

Abstract

Background Living organ donation declined substantially in the United States during the COVID-19 pandemic due to concerns about donor and transplant candidate safety. COVID-19 vaccines might increase confidence in the safety of living organ donation during the pandemic. We assessed informational preferences and perspectives about COVID-19 vaccines among US living organ donors and prospective donors. Methods We conducted a national survey study of organ donors and prospective donors on social media platforms between December 28, 2020 and February 23, 2021. Survey items included multiple choice, visual analogue scale, and open-ended responses. Using multivariable logistic regression, we examined associations between information preferences, history of COVID-19 infection, influenza vaccination history, and COVID-19 vaccine acceptance, and performed a thematic analysis of open-ended responses. Results Among 342 respondents from 47 US states and the District of Columbia, 35% were between 51 and 70 years old, 90% were non-Hispanic White, 87% were women, 82% were living donors (94% kidney), and 18% were in evaluation to donate (75% kidney). The majority planned to, or had, received a COVID-19 vaccination (77%), whereas 11% did not plan to receive a vaccine, and 12% were unsure. Adjusting for demographics and donor characteristics, respondents who receive yearly influenza vaccinations had higher COVID-19 vaccine acceptance than those who do not (adjusted odds ratio [aOR], 5.06; 95% CI, 2.68 to 9.53). Compared with respondents who prioritized medical information sources (e.g., personal physicians and transplant providers), those who prioritized news and social media had lower COVID-19 vaccine acceptance (aOR, 0.34; 95% CI, 0.15 to 0.73). Low perceived personal benefit from vaccination and uncertainty about long-term safety were common themes among those declining COVID-19 vaccines. Conclusions Donor information-source preferences were strongly associated with the likelihood of accepting a COVID-19 vaccine. Vaccine guidance for organ donors who are unsure about COVID-19 vaccines could incorporate messaging about safety and benefits of vaccination for healthy people.