Moderate acceptance of COVID‐19 vaccination in patients pre‐ and post‐heart transplantation: Experiences from a German Transplant Centre

Oehler, Daniel; Bruno, Raphael Romano; Boeken, Udo; Westenfeld, Ralf

INTRODUCTION AND OBJECTIVES: Patients awaiting heart transplantation (HTx) are at increased risk developing severe coronavirus disease 2019 (COVID‐19). Patients supported by a left ventricular assist device (LVAD) face additional risks due to coagulopathies during COVID‐19. Following HTx, elevated risk factors for severe COVID‐19 persist due to chronic immunosuppression and frequent comorbidities. Taken together, COVID‐19 vaccination is of critical importance in all three patient cohorts. Here, we report our experience to deliver COVID‐19 vaccination in a German transplant center. METHODS AND RESULTS: We screened 211 patients for contraindications and offered the remaining 186 eligible patients COVID‐19 vaccination. Of those, 133 patients (71%) accepted the offer and were vaccinated. Acceptance of vaccination differed between HTx recipients (84 of 113, 74%), patients on the waiting list (34 of 47, 72%), and patients with LVAD support (28 of 50, 56%). The LVAD cohort demonstrated lower acceptance levels for vaccination compared to HTx recipients and patients awaiting HTx (74% vs. 56%; p = 0.028). CONCLUSION: We demonstrate for the first time only moderate acceptance levels of COVID‐19 vaccination in HTx recipients and candidates on the waiting list compared to general population, despite perceived high‐risk for severe disease. Additionally, those supported by LVAD have even lower adherence. Efforts may need to be made to increase acceptance in this vulnerable as well as cost‐intensive patient cohort.