Latest NHS advice on COVID-19 vaccine for patients and recipients

17 December 2021

First published 30th June 2021, last updated 17th December 2021.

The NHS recommends that vaccination, including booster doses, is the best protection for everyone from severe disease, risk of hospitalisation and death due to COVID-19.

Recipients of solid organ and islet transplants and patients listed for a transplant were not included in vaccination trials in the UK and there is uncertainty about the level of protection from vaccination in these groups as compared to healthy volunteers and the general population. There is concern that the vaccine may not be as effective for patients who are more vulnerable to infection and, hence, COVID-19 disease due to underlying health conditions, including people who take anti-rejection medication (immunosuppression).

To look at the impact of vaccination and its ability to prevent the most severe forms of COVID-19, combined data from the UK Health Security Agency (UKHSA), which identifies patients testing positive for COVID-19, the National Vaccine Registry and NHS Blood and Transplant (NHSBT) Transplant Registry was used to identify transplant recipients and patients on the transplant waiting list in England who have received one or two doses of the COVID-19 vaccine and who have subsequently tested COVID-19 positive.

Analyses performed by NHSBT support the following recommendations:

  • Two doses of vaccine, regardless of type, in solid organ transplant and islet recipients do not provide the same high level of protection against COVID-19 as for the general population
  • In the absence of any other health contraindication, transplant recipients and patients on the transplant waiting list are strongly encouraged to accept the full course of vaccination (currently three doses of vaccine) and any subsequent booster doses
  • Amongst transplant recipients and patients waiting for a transplant, unvaccinated patients have a significantly increased chance of developing severe disease if they contract SARS-CoV-2 infection in comparison with vaccinated patients

Studies on how best to measure and improve the effectiveness of the response to COVID-19 vaccination in immunosuppressed or immunocompromised patients are on-going. In the meantime, even when vaccinated, it is critical that transplant recipients, patients waiting for a transplant and their close contacts continue to follow all precautions to reduce the risk of infection. These include working from home, social distancing/limiting contact with other people to essential activities, wearing of face masks, handwashing, hand sanitisation).

Does the Covid-19 vaccine affect organ donation and transplantation?

You can receive a transplant whether you have had the Covid-19 vaccination or not, as long as you are eligible. Being on the active waiting-list for a transplant is dependent, not on vaccination status, but a range of clinical factors.

When it comes to donation, you can also be an organ donor regardless of whether you have received the vaccine.

We would always advise people to have the vaccination if possible, as it gives people the best chance of protection against the most severe consequences of Covid.

As transplantation requires a patient to be immunosuppressed, in some cases it may be safer for some patients to hold off or wait for a transplant, rather than undergo the transplant if it will increase their risk of contracting or dying from Covid. The risks versus benefits of transplantation are always discussed in detail with the patient and kept under regular review.

Further advice and information

Follow these links to access more information and guidance around COVID-19 vaccination and current coronavirus restrictions.

NHS Blood and Transplant COVID-19 vaccine Q&As for clinicians and patients

British Transplantation Society COVID-19 information and resources

Government coronavirus advice

NHS COVID-19 vaccination advice