Research Summary

Directed Blood Donations to Avoid Vaccinated Donors Associated With Clinical Harm, Care Delays

Edited by:
Anthony Calabro, MA

Key Highlights

  • All directed donations in the study were requested to avoid blood from vaccinated donors.
  • A total of 13% of patients experienced clinical deterioration while awaiting directed units.
  • A total of 35% of collected units were not transfused to intended recipients.
  • Ethics and transfusion medicine involvement were infrequently documented.

A retrospective single-center study published in Transfusion found that requests for directed blood donation to avoid blood from vaccinated donors were associated with clinical deterioration, care delays, and inefficient use of resources. These requests, which lack scientific support, were evaluated for their real-world clinical and operational impact.

In their study, researchers defined directed donation as blood collected from a specific donor for a designated recipient. For their study, they examined cases in which patients or surrogates refused standard blood components unless sourced from donors perceived to be “unvaccinated.” Researchers reviewed outcomes at Vanderbilt University Medical Center from January 1, 2024, to December 31, 2025.

The investigators conducted a retrospective observational review of patients who received at least 1 directed donor unit. Data collected included patient demographics, clinical scenarios, and documented reasons for directed donation. The team also assessed involvement of transfusion medicine and ethics consultation and evaluated downstream consequences such as procedural delay or cancellation, clinical deterioration, and blood component utilization. Each unit was tracked for type, quantity, and final disposition, including transfusion, reassignment to general inventory, storage, or discard.

Study Findings

Of the 144,856 total blood product units received during the study period, 48 (0.03%) were directed donations for 15 patients, all of which were requested due to concerns about blood from vaccinated donors. A total of 13 patients (87%) were transfused with at least 1 directed unit, accounting for 31 transfused components, including 22 red blood cell units, 5 platelet units, 2 plasma units, and 2 cryoprecipitate units. The median age was 17 years (range, 0.33–73), and 9 of 15 patients (60%) were younger than 18 years.

A total of 17 units (35%) were not transfused to the intended recipients. Seven patients (47%) had at least one collected unit that was not transfused to them. Clinical or operational impacts were documented in 4 patients (27%), including 2 patients (13%) who experienced clinical deterioration while awaiting directed units. These included 1 case of symptomatic anemia with hemoglobin declining to 5.9 g/dL and another involving hemorrhagic shock with a nadir hemoglobin of 3.6 g/dL. Two additional patients experienced surgical delay or cancellation with rescheduling due to directed component availability.

Oversight was limited. An ethics consultation was documented in 1 of 15 cases (7%), and transfusion medicine was notified prior to unit arrival in 1 of 15 cases (7%). The number of patients receiving directed donations increased over time, from 4 in 2024 to 11 in 2025.

Clinical Implications

According to the study authors, these findings suggest that directed donation requests based on donor vaccination concerns are associated with care delays, escalation, and inefficiencies, which may negatively impact patient care. The authors emphasized the need for standardized counseling, documentation, and escalation pathways aligned with existing professional guidance.

The study has several limitations. The cohort was small and limited to cases in which directed units were received, preventing estimation of overall request frequency or characterization of requests resolved prior to collection. Additionally, downstream impacts were captured only when documented and may underestimate the full operational burden.

Expert Commentary

“These requests were associated with clinical deterioration, care delays, and resource inefficiencies when standard inventory products were refused,” the researchers concluded. “The near absence of documented ethics and transfusion medicine oversight in these cases represents a critical gap. Standardized institutional pathways aligned with existing professional guidance may mitigate patient-care risk and operational disruption.”

Reference
Jacobs JW, Hall E, Tahiri T, et al. Directed donations for unvaccinated blood: A departure from evidence-based medicine associated with clinical harm, resource waste, and oversight gaps in a two-year single-center series. Transfusion. Published online March 28, 2026. doi: 10.1111/trf.70195.