COVID-19 Information for Transplant Recipients

COVID-19 vaccination information for transplant recipients continues to evolve. Here are the most recent recommendations from the Henry Ford Transplant Institute:

• Transplant recipients should receive the COVID-19 vaccine as soon as possible.
• All household members and caregivers must also be vaccinated.
• Pre-transplant patients should be vaccinated.
• Anyone who has had COVID-19 should be vaccinated after symptoms end and their quarantine period is over.
• Based on CDC recommendations, there is typically no need to check antibody responses to COVID-19 after vaccination.
• No matter what level of antibody response a transplant recipient has, vaccination will make symptoms less severe, even if they catch COVID-19.
• Since the immune response produced by a transplant recipient may not be as robust as others, they should continue to wear a mask in public and social distance even after they’re vaccinated.
• Immunosuppressive medication dosages for transplant recipients should not be adjusted before COVID-19 vaccination.
• Booster doses and combined vaccine types are being considered by researchers around the country. If there are opportunities to participate in clinical trials at Henry Ford Hospital, they will be announced when available.

For more information, visit the American Society of Transplantation’s website and read this study from the Journal of the American Medical Association.

• Fever
• Cough
• Shortness of breath
• Other flu-like symptoms
• Difficulty breathing
• Chills
• Shaking (with chills)
• Muscle pain
• Headache
• Sore throat
• Loss of taste or smell
• Gastrointestinal symptoms

Most people with COVID-19 have only mild, flu-like and respiratory symptoms which can be managed at home. However, some patients may develop severe pneumonia and breathing problems that require hospitalization. Those with a weak immune system are particularly at risk.

Currently, there are no antivirals or vaccines effective against this virus, although studies to develop these are ongoing.

The complete clinical picture of COVID-19 is not fully understood. While information so far suggests that most COVID-19 illness is mild, serious illness occurs in some cases. Older people and people with certain underlying health conditions like heart disease, lung disease, diabetes, for example, seem to be at greater risk of serious illness. Transplant recipients taking immunosuppressive medications are also at risk of more severe illness. A severe illness can result in death.

The virus is thought to spread mainly from person-to-person; Between people who are in close contact with one another (within about 6 feet), through respiratory droplets produced when an infected person coughs or sneezes. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Given their immunosuppression, transplant patients are felt to be at higher risk for developing COVID infection and having more severe COVID infection, putting them at a higher risk for spreading infection to people around them. It is important to know that COVID-19 may be much more severe than the typical “flu” and severe infections have a greater risk of being fatal.

You may have heard about two kinds of face masks. N95 masks are special masks used in industry and the construction trades, as well as by health care workers in an infectious environment. During this outbreak, the President and national authorities have asked for all N95 masks to be reserved for healthcare workers. The more common face mask is the surgical mask you’re used to seeing in healthcare environments, but even these are currently in limited supply.

The CDC recommends that all people wear a face mask to protect themselves and others from respiratory diseases.

• Avoid close contact with people.
• Avoid busy places and large crowds.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Cover your cough or sneeze with a bent elbow or tissue and then throw the tissue in the trash.
• Wash your hands often with soap and water for at least 20 seconds; especially after going to the bathroom, before eating and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Clean and disinfect high-touch objects and surfaces using a household cleaning spray or wipe.
• Practice “social distancing.” If you must go out, stay at least six feet from others.
• Follow the governor’s orders regarding staying at home.
• If you work, try to work from home as much as you can.
• Avoid exposure to people who are sick.

If you have fever, cough and difficulty breathing, seek medical advice early. Call your transplant coordinator anytime, 24/7. Learn about symptoms, testing and treatment of COVID-19.

It is best to postpone nonessential travel. For up-to-the-minute information, see the U.S. Department of State website. Transplant recipients’ immediate household contacts should also postpone non-essential travel. All plans should be discussed with your transplant coordinator before you travel. If it is critical that you travel, follow all the recommended precautions. More travel advice is available from the Centers for Disease Control.

There are many different causes for fever, cough, shortness of breath, and flu-like symptoms.

If your symptoms are mild, do not come to the hospital or any health care facility without first talking to your transplant coordinator. If you have only mild symptoms we may not want you to come to the clinic, so talk with your transplant coordinator FIRST before coming to any hospital or clinic.

If a close contact is diagnosed with or suspected of having COVID-19, you should avoid all further contact with them. You should avoid sharing common spaces, like a bedroom or bathroom. You should let your transplant coordinator know you have been in contact with someone diagnosed with COVID-19. Then monitor your health and contact your transplant coordinator if you develop fever, cough or shortness of breath.

The risk of acquiring COVID-19 from organ donation is low. Donors are being screened for COVID-19 symptoms and exposure history. They are also being tested for the virus in Michigan and most other states. Living donor transplants are being tested at Henry Ford prior to donation.

Living donors are additionally being asked to not travel for at least 14 days before donation and to watch for symptoms. Information regarding recent travel and possible exposure is also asked about deceased donors to help determine if they are safe candidates for organ and tissue donation.