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First published on October 14, 2022
Changes in the medical screening practices of the Red Cross for blood donor eligibility have been observed. The questionnaires now include the record of receiving the COVID-19 vaccine. The medication deferral list includes the experimental vaccines as they may affect a person’s eligibility to donate blood. When the pandemic began in 2020, the Red Cross began testing blood donors for COVID-19 antibodies but they have completely stopped the procedure and now focus on vaccines.
A person who would like to donate blood to the Red Cross needs to read and answer a list of questions to find out if they are eligible. The Red Cross assures the public that donors who received COVID-19 shots can still give blood as long as they are symptom-free and feeling well at the time of donation. However, under the eligibility guidelines applied to vaccine recipients, a donor needs to provide the name of the manufacturer of the vaccine received to determine the deferral time to be implemented.
A Need for a Greater Blood Supply
Challenges in the blood supply were already present even before the emergence of COVID-19. The pandemic brought about a crisis for blood services as the spread of infection caused cancellations of blood drives. In 2022, the number of weekly cases has continued to decrease, and local governments have started to loosen public health restrictions. The worst part of the pandemic appears to have passed, but crises in the blood supply have not ended.
The concern about blood availability is not due to increased demand for transfusion, but because of the decline in supply due to reduced donations. As a result of the unprecedented blood supply shortage, hospitals are forced to delay or reschedule surgeries. To prevent these problems, the Red Cross continues to encourage the public to donate blood.
COVID-19 Vaccine and Blood Donation
The U.S. Food and Drug Administration (FDA) granted an emergency use authorization (EUA) to Pfizer-BioNTech on December 11, 2020. Since then, different varieties of vaccines have been developed against COVID-19 such as messenger RNA (mRNA), vector vaccine, and protein subunit vaccine. As of October 1, 2022, about 68% of the world’s population has received at least one dose of the COVID-19 vaccine.
With the majority of the population receiving jabs, the screening process for blood now includes the donors’ vaccination status. As part of the Red Cross screening process, the blood donor is asked a series of personal questions to ensure that it is safe for patients to receive their blood and that it is safe for the donor to give blood on the appointed day.
On March 17, 2020, Gail McGovern, president and chief executive officer of the American Red Cross reassured the public that “blood donation is a safe process, and that we have put additional precautions in place at our drive drives.”
Eligibility Guidelines Concerning COVID Shots
Ten organizations, including the World Health Organization (WHO), FDA, and Association for the Advancement of Blood & Biotherapies (AABB), released various recommendations on the deferral periods for blood donors who had received COVID-19 vaccine. The deferral periods range from zero to 28 days, depending on whether the donor received a live or inactivated vaccine.
Among these organizations, the Red Cross follows the eligibility guidelines set by the FDA. Updated information for blood establishments regarding the COVID-19 pandemic and blood donation was released by the FDA on January 11, 2022. It suggests that individuals who received a nonreplicating, inactivated, or mRNA-based vaccine can give blood without a waiting period, and there’s a short waiting period (e.g., 14 days) for donors who received a live-attenuated shot. As a response to these requirements, the Red Cross released the COVID-19 Vaccine & Booster Blood Donation Guide for Donors where the donor is expected to report the name of the vaccine manufacturer during the screening process.
Concerns for the Blood Recipients
There are significant differences in the public’s acceptance of COVID-19 vaccines, and this has also affected the acceptance of blood transfusions from COVID-19 vaccinated donors. Some patients refuse blood transfusions and demand physicians to disclose details of the donor, including whether the donor received a COVID-19 vaccine.
As reported in TrialSite, there are concerns about why vaccinated individuals are allowed to donate blood within two weeks after receiving the shot if the spike proteins circulate in the body for up to a month after mRNA vaccination. A study by the Stanford University Department of Pathology revealed that the blood of Pfizer vaccine recipients contains at least as much spike protein as unvaccinated individuals who were infected by the virus.
The Australian Red Cross advises donors to wait three days after receiving each jab before donating blood, plasma, or platelets regardless of the type of vaccine received because of the possible side effects such as mild fever.
Antibody Testing for Blood Donors
In the early period of the pandemic, the Red Cross tested all blood, platelet, and plasma donations for COVID-19 antibodies. The result helped inform the donors whether they have been exposed to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS Cov-2), the virus that carries COVID-19.
The antibody test was authorized by the FDA and helped indicate if the donor’s immune system had produced antibodies to the coronavirus, regardless of the development of symptoms. It was implemented for a limited time from June 15 – 30, 2020. They discontinued the program when infection rates decreased and new treatment options became available.
A positive result from the antibody test does not confirm infection or immunity, as it only indicates potential exposure to the virus.
Are We Repeating History?
Blood transfusion is one of the most frequently performed medical procedures, yet this practice has historically been mired in controversy such as when African-Americans were banned from donating blood during World War II. This was followed by a lifetime ban on blood donations on men who had sex with men (MSM) during the HIV/AIDS epidemic in the 1980s. During the mid-twentieth century, the U.S. National Blood Program encouraged blood donation and ensured that gender, race, and sexuality would not influence the transfusion process.
Practices in blood donation have improved, but the societal views of it remain controversial. The issues surrounding COVID-19 vaccines have led some patients to get worried about becoming infected with COVID-19 or developing long-term effects from the vaccine itself.
According to the AABB, there is no evidence that donated blood from COVID-19-vaccinated donors may pose a risk to recipients. It recognizes the importance of protecting blood donors and the blood supply by maintaining donor anonymity. Data privacy is also acknowledged by numerous organizations, as they consider it to be crucial in maintaining the relationship between volunteer blood donors and blood transfusion services.
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