What organ transplant recipients need to know about vaccines for COVID-19

If you’re an organ transplant recipient, you may be at an increased risk for contracting COVID-19 and for severe illness should you become infected. Researchers aren’t sure why, but the reasons may in part have to do with your immunosuppressive medications and other medical conditions you may have. Getting vaccinated against COVID-19 is important for all transplant patients.

How safe and effective are these vaccines for transplant recipients?

It’s safe for immunocompromised people to get the Pfizer-BioNTech and Moderna vaccines, according to the Centers for Disease Control and Prevention, because neither vaccine contains live virus that could be dangerous to a person with a weakened immune system. The vaccines both rely on messenger RNA technology to train our immune systems to recognize and defend against SARS-CoV-2, the virus that causes COVID-19. In clinical trials, two doses of the Pfizer or Moderna vaccines were approximately 95 per cent effective in preventing symptoms of COVID-19. When there were breakthrough infections, the disease was generally milder.

It’s safe for immunocompromised people to get the Pfizer-BioNTech and Moderna vaccines because neither vaccine contains live virus that could be dangerous to a person with a weakened immune system.

There’s still no data on the immune response these vaccines generate in people who’ve received organ transplants (transplant recipients were excluded from the original studies).

We know through experience with other vaccines that although transplant patient responses may be less robust, a response still exists and any level of protection is better than none. Even with the lack of data, experts advise that the benefits of vaccination outweigh the risks.

When should an organ transplant recipient get their COVID-19 vaccine?

With few exceptions, get your vaccine as soon as you’re eligible. The same goes for the people who live with you and those on transplant waitlists.

In general, vaccines are recommended to be given at least two weeks before your transplant surgery. If you’ve already had your transplant, doctors will delay your vaccination for at least four weeks and up to several months if you’re still on high dose steroids or have received strong immunosuppressive treatments like thymoglobulin or rituximab. In this case, waiting longer may give the vaccine a better chance to work.

Are there studies focusing on transplant recipients who get the vaccine?

A research team at Johns Hopkins University is inviting all solid organ transplant recipients who plan on getting the COVID-19 vaccine to enroll in a national observational study looking at antibody development and durability after vaccination. Participation involves at-home testing and surveys.

For more information, visit https://transplantvaccine.org.

What are the side effects of the vaccine?

It’s not unusual for some people to experience side effects for a few days after being vaccinated, including fever, chills, fatigue and headaches. Most allergic reactions to the vaccine occur within 30 minutes, which is why people are asked to wait for up to a half hour at the location where they’re being vaccinated. This ensures they’re close to care if they have a serious allergic reaction.

For anyone worried about the vaccine increasing their risk of organ rejection, this link has not been proven for other vaccines and experts believe the COVID-19 vaccines are also unlikely to trigger rejection. Researchers are watching this carefully as organ recipients begin receiving their vaccinations.

Do I still need to get vaccinated if I already had COVID-19?

If you tested positive for COVID-19 and recovered, doctors still recommend you be vaccinated against the virus because we’re not sure how long your natural immunity will last and reinfection is possible. However, if you received convalescent plasma or COVID antibody infusions (bamlanivimab or casirivimab/imdevimab) as part of your treatment for COVID-19, you should wait 90 days before receiving your vaccine in order to give it the best chance of working.

For additional information, see guidance from:

Leaders in Organ Transplantation

Our transplant surgeons are among the best in the world. They have conducted thousands of procedures, earning national and international recognition for their expertise and research.

Learn more about our transplant team

Chicagoland Transplant Care Locations

COVID-19 Vaccine: Expert Q&A

The COVID-19 vaccines are here. How were the vaccines developed so quickly? How safe are they, and what are their side effects? UChicago Medicine experts Dr. Monica Peek and Dr. Stephen Weber answered audience questions in this Q&A.

Video Transcript

The COVID-19 vaccines are here and they are the best way to end the pandemic. How are the vaccines developed so quickly? How safe are they? And what are their side effects? When can we stop wearing masks and social distancing? Experts Dr. Monica Peek and Dr. Stephen Weber will answer all your vaccine related questions, coming up right now on At the Forefront Live

And we want to remind our viewers that today's program is not designed to take the place of a visit with your physician. Let's start off with having each of you introduce yourselves and tell us a little bit about what you do here at UChicago Medicine. And Dr. Peek, I'm going to start with you.

All right, thank you so much for having me. I'm a primary care physician. I am a bioethicist and I'm also a health disparities researcher. And since we've been in the middle of the pandemic, I have been leaning in a lot to learn about how this pandemic is affecting marginalized groups and how we can best try and stem the tide of the pandemic, particularly for those who are most affected.

And Dr. Weber?

Sure. Thanks, Tim. I'm Stephen Weber. I'm an infectious disease doc, an epidemiologist. I'm also the chief medical officer for the University of Chicago Medicine. And in that role, I've helped lead some of the efforts around COVID and then the allocation program, working closely with Dr. Peek and others.

Perfect. We want to remind our viewers that we will take your questions live on the air. So just type them in the comments section. And we'll get to as many as possible over the next half hour. We're going to start off with our two most common questions. We've already received quite a few from viewers on Facebook, in advance. And Dr. Weber, let's start with you on this one. The first question that we get from everybody is, is it safe to get vaccinated?

In some ways, Tim, I think the best way I can answer the question is to say, I see patients. And I was eager to be vaccinated. And I've been vaccinated. So it's just a starting point to say that I value my own safety. I value that of my family. And in electing to get vaccinated when I was offered the chance, that's my shortest answer to it.

The longer answer-- I know the one that some of our viewers want to know-- is how could this be with a vaccine that so seems so new to us? And I like to remind people that this MRN a technology behind the vaccine has been around for a while. We were grateful to see that as it was developed for the last year in labs really around the world, we're seeing not only good effect against this particular virus, but also a really good safety record in tens of thousands of folks who took part in clinical trials, including really diverse groups.

And the last thing I always come back to that question is, you might have a question about vaccine safety. We're glad to try to answer. What we do know is that COVID-19 is really unsafe for humans and for our community. And so that's the alternative. And that's what we really want to encourage people to think about.

So Dr. Peek, probably our second most common question is when can the general public start to get vaccinated? And I know here in the building, we're actually already seeing a little bit of that.

And so we are still technically in 1A, where we're prioritizing health care workers and people who are in long term care facilities. But what the city has given us the go ahead to do is for those bits of vaccine that we have not been able to use, to give those to high risk patients, so that we're not wasting vaccine.

And so here at our institution, we started to just give a few of the vaccines out, so that we're not wasting them. And then we'll begin rolling them out to the general public pretty shortly. And so our goal is to make sure that we have our front facing workers. Oh, that's me-- vaccinated as soon as possible. And then Stephen. And then we'll begin vaccinating our patients. We could not be more excited about the fact that we've been able to vaccinate some of our patients this past week. And we're looking forward to really ramping that up. We just came from a meeting, Dr. Robert and I. And it is our deepest hope, our most gratifying wish, to be able to begin protecting the patients in our community and the patients that we serve every day.

One of the reasons why we're showing the video is it's important for people to see that we're getting vaccinated, as well. It's absolutely we're not just preaching this, then not doing it. We're getting vaccinated, as well. And that showed both of you getting vaccinated. So we do have a sound byte, too, that I want to play. This is from Dr. Kate Mullane, who's also on staff here at UChicago Medicine. And she's going to explain how the vaccines work and why it's safe, correct?

Correct. When you get the vaccine, you do not get any active viral particles. There's many different kinds of vaccines that are out there. There are some like the Johnson & Johnson one, that we'll have data on pretty soon, which is an adenovirus that has the spike protein attached and induces immunity. With the messenger RNA that virus vaccines, there is no active viral particle at all. It's just a small piece of RNA, just the small code for the spike protein.

It's really important to know that there is no tracking device that's involved in the production of the vaccine. There is no way that the RNA can go back into the nucleus of the cell and hook on to our DNA. As soon as that RNA is read, there are enzymes called RNA polmerases that break it up. And so as soon as the recipe's read, it's gone. It doesn't cause infertility. It doesn't customarily. None of those things can happen with the vaccine.

It's very interesting to actually hear about the science behind the vaccine and why it is safe. And Dr. Mullane did a great job explaining. I do want to point one thing out before we go any further in the show. I just noticed a moment ago that we are live, also, on the air or on Facebook with our friends at WGN. So we appreciate that and want to say hello to all the viewers there. And again, we'll take as many questions as we possibly can.

Dr. Peek, we do have some serious challenges with health care disparities in communities of color and COVID, of course. It's just making this even worse. Why do you think it is that many people of color are mistrustful of the COVID vaccine? And what are we doing to try to get the word out that this is a positive thing?

Yeah, there has been-- there's so many reasons why persons of color are particularly mistrustful of this vaccine. I think many people have questions about the newness the technology, how it came to be within less than a year. The pandemic itself is frightening. And so there's just a lot of concern. And then we layer onto that the historical and contemporary injustices within marginalized communities, such as the African-American community, which has suffered disproportionately in 2020, particularly under the administration of Donald Trump.

And so when we have the same administration in play, where a vaccine has been developed. There's just additional concern. But what is important to know is that this is an international collaboration that happens, where multiple companies around the globe are pushing forward to get vaccines developed. And that is a collaboration between scientists and that the technology, the mRNA technology was developed in the 1980s. And that this is something that has been proven safe.

And so I spend a lot of time sort of unpacking all of the reasons why people are concerned and why it's OK to feel that way, but why we have to sort of get past that concern. But the most important thing to know is that our real danger is the virus. It is not the vaccine. It's the virus that is killing. It's causing a 9/11 every day. And that 9/11 is disproportionately impacting Black and Brown people, specifically those that are concentrated in neighborhoods that are primarily Black and Brown. And Chicago is a very racially segregated city. So it's wiping out huge communities.

We are not like many cities that are very diverse. And so where the impact can be shared within the community. And so Chicago, in particular, is taking a sort of a big blow to the face within Black and Brown communities. And so we have to, as a community, decide that we are going to take it anymore. We're going to get behind the science and stand up this vaccine and make sure that we are all as protected as we can be. And we were all going to be vaccine advocates and champions and make sure that everyone that we know and love, those that we hold dear, are ones that we are prioritizing to get vaccinated against the coronavirus.

You know, Dr. Peek, it's interesting. And one of the things that you see COVID being particularly cruel to Black and Brown communities. And one of the ways this was explained to me by one of our Latinx co-workers was a lot of front line workers and a lot of people who really have to go in on a daily basis are from Black and Brown communities. And so they're forced to make a horrible choice. Do I go to work and support my family? Or do I stay home? And we don't have money for food and rent and medicine and things like that, which is a terrible decision, obviously, you have to have to make.

And so this just compounds the challenge of what we're seeing with COVID. And then again, that's why it's so critical. And my hat's off to you obviously, for your work in educating communities to try to really get folks to get vaccinated. We do have another sound byte that I want to play. And this is from some of our co-workers here at UChicago Medicine. And again, if you're worried about getting this vaccine, listen to this because we're going to talk about the experience of getting the vaccine and kind of what they went through. Let's roll that one, John.

It was great. The clinic staff is amazing. And after I had my first dose, exactly 21 days ago, I really didn't have any side effects-- a sore arm, maybe a little bit fatigued. But I'm really excited to be able to complete the series and so grateful for the staff that's working over here.

I would tell them that there's nothing to fear, nothing to be afraid of. My first vaccine was seamless, painless, had a little sore arm afterwards, the next day. But it went away after 24 hours. Nothing to be concerned about. And just to think of the positives over the negatives. The positive of how many lives were able to save by getting this vaccine and versus the fear of the things that we see on social media and on the news. And it's not as fearful, but we have a chance to save so many people's lives, including our own and our family.

I think so much about all of our health care teams that have been part of this pandemic and how many people it's really affected. And so it's less about doing it for me and more about doing it for those that don't have the opportunity to get the vaccine and those that we're really keeping safe and preventing from getting killed.

So Emily and Q are both a couple of rock stars that work here at UChicago Medicine, one of the greater constellation of a lot of rock stars. You guys are obviously included in that category, as well. And we thank them for doing that because again, I think we need to show that it's not the thing to be scared of that a lot of people think it is.

But we're getting a lot of questions about how to register for the vaccine. And I know that's we're a little early on that, but people are asking. And if you can give us some guidance here, that would be really helpful.

Yeah, Dr. Peek mentioned earlier that a number of health systems have been given that latitude that where we have some extra doses that were originally allocated for health care workers to turn to our patients. So what we've done, on our campus, is we've actually identified folks who have had contact with the health system over the past year. And we're actually reaching out to them. We're actually starting off with some of the reasons that Monica mentioned, we're actually starting off with the neighborhoods right around the Medical Center, recognizing that community, both historically and too often temporarily, is missing out on some access to care.

And so we have made our first outreach. And people are hearing about it through either our medical records system, telephone calls, and also, texting. Because we realize we've got to meet people where they're at, both in terms of emotion and culture, this, but also technologically, too. As we go forward, we'll keep broadening that within our system. I think similar things are happening as some of the other health systems.

Where it will really change and where folks will look for the opportunity to enroll or sign up is going to be as the whole city moves into this 1B, 1B being now for individuals over the age of 65 and then some selected front line essential workers. And what we understand from the Department of Public Health is they want to have some more centralized registration opportunities. But there is a matter of paying attention and keeping an eye out through your primary care doc, through your local hospital. In some ways, Tim, we're working this through right now, collectively, as a society. We see that those differences, state to state.

But what I will tell people is this-- if you have an opportunity, by way of that primary doctor or maybe the hospital you visit a while ago or perhaps there's a vaccination center being set up by the city in your neighborhood, we want you to take advantage of that when your time comes. We know that there are some bad actors out there, who are starting to run scams and things like that around vaccine. Obviously, this could be a lot more to track in terms of that. But for right now, for those providers that you know, those systems that you already trust, look for them to be reaching out to you and also to reach out to them.

I suspect, as we go forward, this will become much, much more clear. So the questions are understandable. But we're still much closer to the beginning than to the end of all of this. And we're getting our practice in, for sure.

Sounds good. We're getting some more specific questions now from our viewers. Dr. Peek, I'll throw this one to you. My 91-year-old father-in-law will be moving to an assisted living facility soon. Should we wait until after he's vaccinated or go ahead and-- or excuse me. Should we wait until after he is vaccinated to move him?

So I guess it depends on when he was being planned. Like are the moving trucks there now? Or is this something that's still in their mind? And so long term care facilities are vaccinating right now. And so if he moves, he could get vaccinated as soon as he gets there. And so I wouldn't necessarily hold up plans that are already in place right now.

On the other hand, if this is something that is still being thought about, several months away, then we anticipate fairly soon the father-in-law should be able to get vaccinated. And then you could. So either way, this person will get vaccinated in the near future. And so I would think more specifically to the timeline of the move in process. Because I know how hard it is to sell something and to, in Chicago, all of those logistics. This person is going to get vaccinated fairly soon.

That's a really good point. If they are moving quickly, they should probably just contact the care facility. And they'll tell them if they move in x amount of days, they'll be able to get him vaccinated, which would be kind of an added bonus to actually moving. So Dr. Weber, this one's also from a viewer. Can you discuss the different vaccines? We've heard about Johnson & Johnson, coming up soon. What are the pros and cons? And should people wait for that one?

Yeah, it's a great question. Again, another space where there's so much information that it's hard to sort through. So we'll do our best to try to provide a little more context for it. The two vaccines that are available right now in the US are the Moderna vaccine and the Pfizer vaccine. Both of those vaccines require two injections. For the Pfizer, it's after three weeks and Moderna after four weeks. There's been conversations in the news about, gosh, maybe we should just give one dose of that, hold the other. The bottom line is right now what we know and what we've studied, what we understand, is giving two doses, each of those vaccines.

Seemingly, the next vaccine that will come available in the US, we hope, is going to be the Janssen vaccine, which is a one dose vaccine, as mentioned by Dr. Mullane earlier in her example. That vaccine is still yet to get what's called the emergency use authorization from the FDA. We believe that the company is going to submit that information fairly soon. So we may have an answer about that in the next several weeks.

The only hesitation that's changed on that vaccine now is that there's been some production delays. No problem with the vaccine itself, but just in building up the number of doses they need. So there might be a little bit of a delay. I'll go back to what I said earlier, and even thinking about what Dr. Peek just said about the instances that was just mentioned, if there's a vaccine available, I would take that vaccine. And I'm not trying to be glib or make a joke about it. But a vaccine that's available to you and that can be administered is going to be preferable to being unvaccinated or waiting for a date, for example, for the Janssen vaccine to come through.

The two dose vaccines, Moderna and Pfizer, both have similar effectiveness in their clinical trials of more than 90%, which is outstanding. We'll wait to see for Janssen. We hope it's a similar number. Maybe some tough decisions if it underperforms a little bit. We just don't know yet. But again, I still stick to my advice which I've given to my patients, to my family across the country, which is if you have that opportunity for vaccine, I'd get that vaccine now, either of those that are available right now.

Excellent. So Dr. Peek, we know it's very important to get the vaccine. What strategies have you found to be effective when you're talking to your patients, that maybe people have family or friends who are hesitant to take this vaccine?

Yeah, I was actually just talking to someone, one of our employees, in the hallway a couple of hours ago. So every time I see someone on campus and I was like, did you get the vaccine? And just to listen with an open heart and an open mind, to understand what their concerns are, because they're coming from a place of rational thought. It may not be, their fears may not be founded in science. But they're logical concerns. And they're also usually rooted in fear.

And so we have to not just feed people's minds with the facts, but we have to walk them through and past their fears. We have to hold their hands through this emotional journey. No matter how much understanding people have, they have to get past their emotional barriers. And so you have to, almost like a therapy session, hear them out and let them unpack all of that pain that is there that is keeping them from having that vaccine. And then talk to them about what we know to be true, what we to be the reasons for why the vaccine is a good thing for this person and for our community.

And then try to see if there's anything else that's outstanding. But it's really just a conversation that it's an iterative conversation. And we may in that conversation with just moving a little bit forward, with just a promise that we'll think about it. I may not get to, yes. But I can get to maybe. And that may be good enough. And then the next time, we'll pick it up. And so this is not my patient. But it's an employee that I see all the time. And I say, next time I see you, we'll just continue to check in.

And so it's for most people who are vaccine hesitant, there's something emotional that's keeping them from getting the vaccine. And so I think that, for me, I found is that getting myself into an emotional space with them has been more effective than coming with a stack of fliers and passing those out.

Well, that makes sense. I think, so kind of a follow up question to that, Monica, is another viewer is asking about allergies to penicillin. Does that have any kind of impact on that? Perfect.

All right, so Stephen, this one's for you. And this is another viewer question. What are your recommendations for pregnant women, lactating women, and women considering pregnancy? That's a question we have heard a lot.

This is a really important question. And one for which-- and you keep tossing me these questions, Tim, and I'll--

But we have to answer, where there's any uncertainty, we want to answer with candor, as I said a moment ago. As the vaccine became available, there were a lot of questions around this. And what we saw right away was an acknowledgment from the folks who developed the vaccine that the vaccines were not tested in enormous numbers of pregnant women. In fact, in some of the studies, pregnant women were excluded. But they were able to study safety because a number of the participants in the trial became pregnant during the trial.

What we saw right away was that some of the real trusted authoritative bodies for obstetrical care, including the College of Obstetrics and Gynecology, Maternal Fetal Medicine Society, came out right away. And they said we recommend to patients and in their case, providers to recommend to patients that they be vaccinated because they felt there was enough information to say that because the consequences of COVID can be so severe for pregnant women, that they wanted to make sure that they were protected and that the vaccine with the information available was a better choice.

We've actually undertaken-- we've done a town hall for pregnant women among our employees or women thinking of being pregnant or those who are breastfeeding, from similar decisions come to mind. And right now, we've seen folks just making some decisions, talking to their obstetrician, talking to their families to make the right decision for them. But on balance, the expert opinion is to say that the vaccine can be safe for pregnant women, those who are thinking of becoming pregnant, or those who are breastfeeding. And I think right now, we'll continue to track it. But it's been my advice to my patients who happen to be pregnant to go ahead and be vaccinated because the consequences of COVID can be so severe.

We're just about out of time. But there's a couple of questions I want to get to before we get out. So I'll quickly ask these two. Dr. Peek, let's start with you. Do we know how long the vaccine will last? It's a viewer question. Will this be a yearly thing?

We don't know for sure right now what the durability of the vaccine is. And we've already seen mutations of the virus, some of which are making it more infective. But what we know is that this is what viruses do. This is the reason that we have to get a flu shot every season. It's not because the flu vaccine has worn off. It's because the flu virus itself mutates every year. And so we have to get vaccinated against the new strain of flu. It's not that we're no longer vaccinated-- that the vaccine has worn off against last year's flu. We're still protected against last year's flu. We have to get protection against this year's flu.

And so it may be that one of the things we do know is that the rate of mutation for the coronavirus is actually much, much slower than it is for many of the other coronaviruses that we know of, at least so far. And so we don't know how this is going to play out, if we're going to need to have annual vaccines for a coronavirus or not. So it's still too early to tell. But viruses mutate as part of just who they are. And so I think we're fortunate that the rate of change has been slower than it could have been and the data that we have about duration, I think, is-- Dr. Weber, help me out. I think it's more promising than we thought it was going to be. But we don't have definitive data.

I think the early returns are somewhat favorable, to borrow from the other news these days. But I think we will need to wait and see. Again, and it's another place where we want to be very candid and honest. We want to listen to all the questions and give the best answer we can now. But we don't need to keep having these conversations as we go forward.

So we are a little bit over time. But Dr. Weber, I'm going to give you the last question because I just think this is an important one. And this actually is something that you and I talked about a little bit the other day. First of all, if I'm vaccinated, can I still get my loved ones sick? And when can we stop wearing masks?

Yeah, this is a tricky one. And one that again, we're going to learn a lot more about. What we know right now is the vaccines were designed to prevent us from getting sick, an individual from getting sick, when we're exposed to the virus. What we don't yet know is the impact of the vaccine on our ability to acquire the virus, maybe transmit the virus to our loved ones at home, or those of us working in health care or elsewhere.

So right now, the recommendations are still going to be that we have to be as strict as we have been-- in some cases, more strict-- to help prevent transmission, even after we've been vaccinated. And that may not make sense to everybody right away. But understand about what we faced with this pandemic. And if we find that we've been a little extra cautious, I'm willing to apologize for that later. But for right now, what we need to do is maintain our guard, maintain our vigilance. Because biologically, we can't say, for sure, that someone who's been vaccinated is unable to transmit the virus to someone who's in close and unprotected contact with them.

We are out of time. You were both fantastic and shared a lot of great information with our audience. So thank you very much for doing this. I know you're both busy. Thank you to our viewers for your fantastic questions. And please, remember to check out our Facebook page for a schedule of programs that are coming up in the future.

To make an appointment with our post COVID recovery clinic, give us a call at 773-702-7826. To learn more about UCM's COVID-19 vaccination program, you can visit our website UChicagomedicine.org/COVIDvaccine. Thanks again for being with us today and hope you all have a great week.

We put your safety at the forefront. Schedule a safe in-person visit or video appointment today. Because your health needs don't stop and neither do we. UChicago Medicine, at the forefront.