Vezna Hang has a son. Hang needed a double lung transplant after falling ill with COVID-19. He encourages others to get the shot.
According to UNOS, about one in 10 lung transplants in the United States now go to COVID-19 patients.
The ethics of allocating a scarce resource to people who have chosen not to bevaccinated against the coronaviruses is being questioned.
They are accumulating on a regular basis. David Klassen is the chief medical officer for UNOS.
He believes the number of transplants would be greater if there were more lungs available.
The latest UNOS figures show that since the first such operations were tracked in August of 2020, 238 people across the country have received lung transplants due to COVID-19.
According to UNOS data, lung transplants for COVID patients rose tenfold between the first year of the pandemic and the year 2021, while transplants for other lung diseases are down compared to prior years.
It's happening in both the US and Canada. There was a paper out of Western Canada that said there was a huge increase in lung transplants there. The chair of the Yale-New Haven Health Transplantation Center says it's a big problem.
A double lung transplant in the U.S. costs around $1 million, and is done more than 2,000 times a year.
The rise in COVID-related transplants is forcing doctors to grapple with how to best manage who gets them, especially now that vaccines are widely available.
"When someone contracts a lung transplant and they refuse to get a vaccine, it's a really ethical dilemma," says Mulligan. "How can they just jump in and take a lung away from someone who's sick, but has been doing the best they can to take care of themselves and avoid getting Covid?"
Non-judgment is ethics.
People who need an organ are weighed by transplant centers. Social and behavioral factors are not usually included.
If you've stayed smoke-free or sober for six months, you can be listed for a new liver, just like if you've been drinking too much.
In medicine, not judging people's past behavior is standard. When it comes to transplants, future behavior is fair game according to an assistant professor of medicine.
Kates thinks that the next set of lungs of COVID-19 patients should not be subject to the same risk because they should be able to demonstrate immunity.
Patients who are not protected against coronaviruses will lose their spot on the transplant list.
Some say that it may be unfair to eliminate people who haven't had a vaccine from being considered for an organ because they have lower vaccination rates.
The current system of waiting for a transplant tries to prioritize people who can't wait much longer for their organ, but who have a good chance of being able to benefit and keep that organ, says Govind Persad, who teaches bioethics and health law.
The only option is a transplant.
Vezna Hang is a candidate for lung transplants after COVID-19. He moved to the area from New York in March of this year. His symptoms were not very noticeable, just a loss of taste and smell.
He says that one day he looked in the mirror and saw his lips and fingertips were blue.
Hang did not have any underlying conditions. His lungs were inflammation that resulted in permanent scars. His only other option was a transplant.
I was scared for the first time. I didn't think I was going to make it from day to day. I wanted to leave behind my son.
Hang did not get his vaccine when he fell ill. After he got sick, Florida opened up vaccine access to his age group, 40 and up.
Hang knows people who are unsure about getting the shot. He says he was one of them.
Everyone is different by this horrible virus. Hang says it's not predictable.
It made me push to get myself and my family vaccine, because I saw all the people that weren't vaccine-free being hospitalized.
The dilemma of caregivers.
There isn't a national policy on how to handle vaccine refusal when it comes to transplants. The American Society of Transplant Surgeons recommends vaccinations for people waiting for a transplant. The immune response is stronger if a patient gets the vaccine before their transplant.
It's not the patients who are difficult to convince according to Deborah Adey, a kidney transplant specialist at the University of California San Francisco.
Adey has seen patients who were transplants years ago fall dangerously ill with COVID after living with unvaccinated family members.
Anti-vaxxers have always been around. That is not new. This degree of resistance to doing something for the public good? I've never seen anything like this before.
The executive director of the transplant institute at the hospital says that community exposure poses serious risks.
Several transplant patients died of chronic bronchitis in the last surge. The patients that were for the majority of the population, but who had their immune systems suppressed, didn't have the same degree of protection as a normal individual would.
People who live with donated organs must take immune-suppressing drugs for life in order to prevent their bodies from attacking and rejecting the new organs, making them more vulnerable to COVID-19 as long as it's around.