Oct. 17—Sherry Breen has waited nearly seven years to get to the top of Geisinger's kidney transplant list but her refusal to get a COVID-19 vaccination may keep her from getting the life-saving surgery.
Across the country, growing numbers of transplant programs have chosen to either bar patients who refuse to take the widely available COVID vaccines from receiving transplants, or give them lower priority on crowded organ waitlists. Other programs, however, say they plan no such restrictions — for now. According to Kaiser Health News, at issue is whether transplant patients who refuse the shots are not only putting themselves at greater risk for serious illness and death from COVID, but also squandering scarce organs that could benefit others.
"I am not anti-vaccine, but there have been no long-term studies done on it and my doctor couldn't guarantee how my body would react to it," said Breen, a 40-year-old Muncy Realtor. "A kidney transplant is life-saving surgery and I'm being disqualified because I'm scared."
On Sept. 28, Breen received a letter from Dr. Michael Marvin, the chairman of Geisinger's organ transplant department, and Dr. Stanley Martin, division director of infectious diseases, notifying her that she would be placed on the inactive list and not be eligible for a transplant if she declined to be vaccinated or show proof of vaccination against COVID-19
"If you choose not to be vaccinated, you will need to wait until after the spread of COVID goes down to a safer level before being made 'active' on the list again," the letter said. "During this time you do not lose any waiting time and your waiting time will continue to increase as if this status change was not in effect."
Breen said her concern is how the vaccine will affect her immune system, particularly since a bout with COVID-19 last November had a significant impact on her health.
"For three or four days I wasn't sure if I would live. I got septic arthritis and even lost all my long red hair," she said. "I've waited years to get to the top of the transplant list but I know my body and I'm afraid of what the vaccine will do to me. I'm worried I'll end up in worse condition and I just don't want to rock the boat and make my body sicker."
Geisinger spokesman Joseph Stender said the hospital's policy against performing organ transplant's on patients who are not vaccinated against COVID-19 is "based on overwhelming data and recommendations from countless experts, including the American Society of Transplantation.
"It's our obligation to deliver the safest, highest-quality care, especially for immunocompromised patients like transplant recipients who are at a higher risk of severe complications from COVID-19," he said. "Just like requirements for our transplant patients to have colonoscopies, CT scans, pap smears and more to keep them safe and increase the likelihood of a successful transplant, requiring the COVID-19 vaccine will help our patients safely undergo and recover from their transplant surgeries."
Stender cited privacy reasons for not divulging how many organ transplant candidates at Geisinger have been put on the "inactive" list for refusing the COVID-19 vaccine. No other medical procedures at the hospital require the vaccine, he said.
Evangelical Community Hospital in Lewisburg does not perform organ transplants. The hospital does not require COVID vaccinations for any medical procedures or treatment, said spokeswoman Deanna Hollenbach.
Several hospitals across the country that perform organ transplants do require the vaccination, including UCHealth in Denver, Colorado, and UW Medicine in Seattle, Ore., but many of the more than 250 organ transplant centers in the U.S. do not.
Included among the hospitals that don't require COVID-19 vaccinations for organ transplantation are UPMC and Highmark's Allegheny Health Network in Pennsylvania.
UPMC spokeswoman Andrea Kunicky said the hospital is continuing to advocate for the vaccine and make them easily available to everyone.
Highmark's Allegheny Health Network spokeswoman Catherine Clements said a majority of its patients in the abdominal and cardiovascular transplant programs have heeded the recommendation to get the COVID-19 vaccine.
Northwestern Medicine in Chicago, where the first double-lung transplant was performed on a COVID patient in June 2020, is encouraging — but not requiring — the vaccination.
Inconsistent policies are sending a mixed message to the public, said Dr. Kapilkumar Patel, director of the lung transplant program at Tampa General Hospital in Florida, where COVID vaccines are not required.
"We mandate hepatitis and influenza vaccines, and nobody has an issue with that," he said. "And now we have this one vaccination that can save lives and make an impact on the post-transplant recovery phase. And we have this huge uproar from the public."
Nearly 107,000 people are waiting for organs in the U.S and dozens of transplant candidates die each day. Transplant centers evaluate which patients are allowed to be placed on the national list, taking into account medical criteria and other factors like financial means and social support to ensure that donor organs won't fail.
"We really make all kinds of selective value judgments," said Dr. David Weill, former director of Stanford University Medical Center's lung and heart-lung transplant program who now works as a consultant. "When we're selecting in the committee room, I hear the most subjective, value-based judgments about people's lives. This is just another thing."
Breen was diagnosed with late-stage kidney disease in January 2016 after her immune system was severely compromised since contracting Lyme disease at age 20.
For nearly seven years she's been on peritoneal dialysis, a daily process that lasts about 12 hours and reduces excess fluid and removes toxins from her kidneys.
"I start at around midnight and go off at 7 a.m.," said Breen, who then does more dialysis a few hours during the daytime.
The average life expectancy for an individual on peritoneal dialysis is six to eight years, she said.
Breen said she asked Geisinger for a waiver, allowing her to get the kidney transplant despite her refusal to get the vaccination, but was denied.
"I'm a mom and a wife. My life matters to them," she said of her husband, Andy Breen, and two sons from a prior relationship, Ross Eyer, 16, and Stiles Eyer, 14. Neither her husband or sons have been vaccinated against COVID-19, she said.
Andy Breen, who also had the virus last year, said he supports his wife's decision not to get vaccinated despite the potential consequences of giving up her spot on the transplant list for now.
"There's always fear" the longer she's on dialysis, he said. "But if I had to roll my wife's life on a roulette wheel for one shot, I wouldn't."
Andy Breen said he's just "trying to keep my wits about me," while his wife relies on her faith.
"I know something good will come from this. God is in control," she said.
The Tribune-Review and Kaiser Health News contributed to this article.