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Horowitz: Man with prior infection denied kidney transplant for refusing to get COVID shot

Op-ed
Natalia Semenova/Getty Images

Someone with prior COVID infection can play in the NCAA without getting a shot, but someone who recovered from the virus and needs a kidney cannot get a transplant in many parts of the country. Hospitals are now requiring all patients to get a shot that has proven to barely stimulate immunity for immunocompromised people with failing organs, even if they have more robust natural immunity. The latest case of UVA Health denying a kidney to Shamgar Connors is as immoral as it is illogical and anti-science.

Shamgar Connors told Newsmax’s Grant Stinchfield last week that he was dropped from the active kidney transplant waiting list at UVA Health in Charlottesville, Virginia, for refusing to get the COVID shots. "I have natural immunity now,” said Shamgar, who is in stage V kidney failure and on dialysis every day. “It's like, why would I get a vaccine now for something I'm immune to, that's like saying I need a vaccine for chicken pox after I had it."

This is the point Connors made to Dr. Karen Warburton, the nephrologist at UVA Health, who informed him that he would be dropped from the donor list without the shots. Connors recorded the phone conversation with Warburton, in which she clearly was unaware of any of the academic papers regarding the efficacy of the shots vs. natural immunity, particularly for those who are immunocompromised.

UVA denying me a kidney transplant because i refuse to get the vaxx www.youtube.com

When Connors told her he already had COVID, Warburton said, “You may have had Delta, and that may not protect you against the Omicron variant, which is what we’re seeing now.”

The problem with that statement is that although it’s true that one can get Omicron despite prior infection, the vaccines appear to work even less than prior infection! Moreover, even before Omicron, there was no evidence that the shots protected organ transplant patients with robust immunity, and quite the contrary, one study clearly showed that prior infection provided much better immunity against serious illness in solid organ transplant patients than the shots.

While the notion that someone concerned with the risk of the shots would be denied a transplant is shocking, the only rationale one could conceive is that they don’t want to “waste” a kidney on someone they believe might die from COVID. But if that is the rationale, then the shots themselves offer very little protection, not nearly as much as natural infection. Moreover, it shows that not only are nephrologists who engage in this discrimination against science, they are also derelict in their duty of treating organ transplant patients with known therapeutics that work as opposed to relying upon failed shots.

Researchers at Toronto's University Health Network (UHN) Transplant Centre studied the T cell responses in organ transplant patients who had prior infection without the shots vs. those who had the shots without prior infection. The science shows the exact opposite of what Dr. Warburton told this man in dire need of a transplant.

"Vaccinated SOTRs mounted significantly lower proportions of S-specific polyfunctional CD4 + T-cells after two doses, relative to unvaccinated SOTRs with prior COVID-19," concluded the authors of the study, published in the Journal of Infectious Diseases last month. "Together, these results suggest that SOTR generate robust T-cell responses following natural infection that correlate with disease severity but generate comparatively lower T-cell responses following mRNA vaccination."

In other words, even immunocompromised people will likely mount a strong enough T cell response to ensure that even if they get reinfected, they will not get seriously ill. Yet, those without prior infection but with the shots showed very little T cell response even 4-6 weeks after the shots – the sweet spot of the vaccine’s efficacy. And again, that was against the previous variants, not Omicron, which clearly does not respond to the shots.

It was known from early on that the shots had very limited efficacy for organ transplant patients. In April 2021, Mayo Clinic researchers published their findings in the American Journal of Transplantation that solid organ transplant patients enjoy limited antibody responses from the shots. “We report seven SOTs with undetectable or low titer antispike antibodies who developed COVID-19 infection after receiving one or two doses of the SARS-CoV-2 mRNA vaccine,” wrote the authors in a letter to the journal. “The clinical presentation and course of these patients were comparable to those of SOTs who had COVID-19 infection and have not been vaccinated.”

A Hopkins study published as a letter in JAMA last March found that only 17% of a sample of 436 organ transplant patients had detectable antibodies from the Moderna shots. “Our study shows that [immunity] is unlikely for most transplant patients, and one could guess that our findings could also apply to other immunosuppressed patients, such as those with autoimmune conditions,” Johns Hopkins University surgeon Dorry Segev wrote in Medpage Today.

In other words, rather than lying to these patients and giving them false hope in the shots, they should be working on treatments. This past month I have referred two kidney transplant patients to doctors willing to treat them for COVID after their nephrologists offered them nothing when their COVID shots failed to stimulate immunity. They both responded well to treatments, which included prednisone, ivermectin, nebulized budesonide, and several other treatments that didn’t interact with the medications they were on.

One of those doctors aggressively treating COVID in vulnerable patients among friends of mine was Dr. Richard Amerling, a board-certified internist and nephrologist. “Once transplanted, organ recipients respond poorly to vaccination,” said Amerling. “Early treatment is their best option. Dosages of various immunosuppressive drugs may need adjustment, with close monitoring of serum levels. Monoclonal antibody treatment is probably safe and effective, but should also be studied. Based on known nephrotoxicity, remedesivir should not be used.”

Amerling notes that “a randomized controlled trial in patients with advanced kidney failure is needed before recommending, let alone requiring, vaccination. Adverse events in the highly vulnerable population could be considerable.” He warns that “the denial of organ transplantation based on unvaccinated status is anti-scientific, anti-Hippocratic, and highly unethical. It is an extreme example of ‘one-size-fits-all’ protocol/guideline-based medicine.

Yet, without any evidence, doctors are denying transplants. “The science is pretty clear on the vaccine,” said Dr. Warburton to Mr. Connors. Well, indeed it’s clear that transplant patients could never count on the shots for their lives, which is why most of them are still locked in their homes. The science is also pretty clear that the vaccine does not work against Omicron, and if anything, seems to stimulate the virus more than the unvaccinated.

The hospital rate among the vaccinated is now higher than the unvaccinated in Scotland, and the case rates are even higher. According to an Israeli study, even four shots don’t work against Omicron. The only thing that clearly works is early treatment. For doctors to deny early treatment to all patients, and now kidney transplants to those without shots that neither affect other people nor stimulate robust immunity for themselves, is reminiscent of very dark times in history.

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