Department of Transplant Medicine, Fresenius Medical Care, Charlotte, North Carolina.
Am J Transplant. 2022 Feb;22(2):381-385. doi: 10.1111/ajt.16891. Epub 2021 Nov 24.
The question of whether transplant clinicians should mandate COVID-19 vaccination as a condition of transplant candidacy is complex. A vaccine mandate may be defensible on the grounds that transplant clinicians are obligated to ensure transplantation is conducted safely, and in a manner that entails the best use of a scarce public good. However, mandate proponents will inexorably predicate their arguments on contingent clinical judgments that meliorate rather than resolve core value disagreements. Vaccine mandates are conceivably defensible on narrow grounds, but may prove to be purchased at the expense of an attenuation of shared decision-making, proffering claims of risk reduction from a vaccine mandate beyond what the current evidence base supports, and unintentionally exacerbating durable inequities in access to transplantation.
移植临床医生是否应该将 COVID-19 疫苗接种作为移植候选条件的问题很复杂。从移植临床医生有义务确保移植安全进行，并且以最佳利用稀缺公共资源的方式进行的角度来看，疫苗强制接种可能是有道理的。然而，强制接种的支持者将不可避免地根据改善而不是解决核心价值观分歧的偶然临床判断来预先判断他们的论点。疫苗强制接种在狭隘的范围内可能是有道理的，但可能会以削弱共享决策为代价，提出疫苗强制接种可以降低风险的主张，超出当前证据基础所支持的范围，并无意中加剧获得移植的持久不平等。
