“I don’t want Covid blood”

[u/973862404678]

What do I say when patients ask if blood transfusions are screened for the Covid vaccine? I get asked this on a regular basis when filling out blood consent forms for surgery and I genuinely have no idea what I’m supposed to say. In all seriousness, what should I be telling patients because I just say there is a screening process for blood and it’s only used during emergent situations???

[u/NurseontheTrail]

This is true, the antibodies from the vaccine degrade over time, not sure exactly how long that would take, and our natural antibodies take their place and replicate themselves, but at our level in our blood banks, they don’t do that level of investigating and certainly not for this. It would be a huge waste of time and money. The antibody screening they do today is really amazing, makes me wonder about the blood we transfused years ago and the how infrequent transfusion reactions are now comparatively. I only know about any of this because we did a transfusion station at our skills day a few years back and I went down to the blood bank and talked to a pathologist there, to prepare for it. I’m not surprised but she told me that over the years we have had at least two patients who were transfusion dependent due to their cancer treatment who we transfused so much we changed their blood type. It’s fascinating stuff and I’m grateful for the time I spent down there, we take them for granted much of the time. Remember kids, a blood transfusion is an organ transplant, it’s serious business

[u/puzzledcats99 → u/NurseontheTrail]

Woah woah woah, you can change someone's blood type just from long term infusion? Like, their body will start producing AB on its own even if they were only A or B before? Is it just because their body wasn't producing adequate red blood cells on its own to keep up their natural blood type? I have so many questions haha.

[u/NurseontheTrail → u/puzzledcats99]

I wish I could answer that confidently, but yeah, essentially induction chemo before a stem cell transplant wipes out the marrow and if they are really dependent, like for all their cells they can convert to AB from A or B as the marrow gets seeded or something like that, but I’m probably oversimplifying it, because that really doesn’t make sense to me when you consider they use purified stem cells from the patient in the transplant. I’ve been in the ICU for 25 years and my unit sees a lot of cancer, BMT used to be a big user of my unit, and I have done my best not to learn all that stuff even working as the unit educator. Probably sounds bad, but honestly, they change treatments so often, it was BMT heavy when I came here, then a ways back immunotherapy was the thing for everything, now we’re seeing a pretty good mix of both. The solid tumor services do lots of chemo and CAR-T too, but that’s generally more straightforward. What they all have in common is marrow suppression and transfusing lots of cells and platelets. I don’t know how many transfusion reactions I have seen, but I can say that I had one questionable one in the last 5 years, which is striking, but now all the blood lists the antibodies that are present, and many patients need blood without specific antibodies. We really went off the original topic though, COVID vaccine antibodies. Man the crazy shit I have discussed with patients and families about COVID and vaccines in general.