UPDATE: After deadline, Forum News Service received additional information from CHI St. Alexius Health and Sanford Health. CHI confirmed it doesn't conduct transplants. Sanford Health noted it does in fact require COVID-19 vaccinations for transplants, but only for bone marrow transplants at a North Dakota facility. This information has been added to the article below and the headline has been changed to represent the update.

SIOUX FALLS, S.D. — While some U.S. health systems now require transplant patients and donors be vaccinated against COVID-19, most major health systems in the Upper Midwest aren't making vaccinations a broad condition for transplants, according to a Forum News Service review.

With one exception: Sanford Health and bone marrow transplants at its Fargo, North Dakota, cancer center.

Of five major health systems in the region, Only Sanford now requires some transplant patients or donors get the COVID-19 vaccine prior to their procedures, their representatives said. Forum News Service spoke with Mayo Clinic, Sanford Health, CHI Essentia Health and Avera Health.

  • Mayo Clinic: The Rochester, Minnesota-based health system doesn't require but "strongly recommends" COVID-19 vaccinations for both pre- and post-transplant patients — for now. Said a Mayo spokesperson: "Mayo Clinic is in the process of reviewing its vaccination guidelines for transplant patients."
  • Sanford Health: The Sioux Falls, South Dakota-based health system, doesn't broadly require transplant donors or recipients be vaccinated against COVID-19, with the exception of bone marrow transplants at its Roger Maris Cancer Center in Fargo. It does perform rapid testing for the virus before commencing transplant procedures and will postpone the procedure or decline an organ offer if the test is positive.
  • Essentia Health: The Duluth, Minnesota-based health system, reported it doesn't do transplants at its facilities.
  • CHI St. Alexius Health: The health system in North Dakota doesn't offer transplants within its facilities.
  • Avera Health: The Sioux Falls-based health system does not require transplant recipients or donors get the COVID-19 vaccine, but does strongly encourage bone and marrow transplants patients to get vaccinated and encourages solid organ transplant patients to consult with their physician regarding the vaccine.

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Colorado case sparks debate

The transplant issue became a national question after UC Health, a Colorado-based health system, denied an kidney transplant to a patient because she was unvaccinated against COVID-19, according to a letter to her publicly disclosed by a state representative. In the letter, UC Health told the patient she would be inactivated from the kidney transplant waiting list and had 30 days to get vaccinated or she would be removed from the list.

UC Health, which faced a firestorm of criticism from some quarters for the decision, told media outlets the requirement wasn't unique, and one of many conditions transplant centers require of patients, including other vaccinations, stopping smoking, avoiding alcohol and uptake of critical anti-rejection medications.

UC Health pointed to a broad November 2020 study showing kidney transplant patients are at far greater risk at dying from COVID-19. Those who contracted COVID-19 had a 21% mortality rate, while other studies ranged from 18%-32%, compared to a overall mortality rate of 1.6%.

"This is why it is essential that both the recipient and the living donor be vaccinated and take other precautions prior to undergoing transplant surgery," UC Health said in its statement. "Surgeries may be postponed until patients take all required precautions in order to give them the best chance at positive outcomes."

Additional reporting revealed other health systems nationwide have implemented similar guidelines. The national nonprofit network United Network for Organ Sharing, which coordinates organ donations, told The Washington Post it doesn't set requirements for transplants, but leaves such decisions up to transplant centers.