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Narrative Medicine

We Need Blood and I Am Not Allowed to Help

Educational Objective
To understand how antiquated and bigoted rules regarding blood donations is affecting our ability to manage COVID-19

1 Credit CME

JAMA Internal Medicine

Published Online: September 8, 2020

Perspective

Article Information and Disclosures

Greg J. Zahner, MD, MSc^1,2

Author Affiliations

¹Department of Medicine, Massachusetts General Hospital, Boston
²Harvard Medical School, Boston, Massachusetts

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This summer I became a physician at the height of the coronavirus disease 2019 (COVID-19) global pandemic. While I will be fighting on the front lines, I will not be able to donate blood to fight the growing national crisis for blood donations. Additionally, if I become infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and survive, I will not be able to donate my convalescent plasma, a potentially important treatment. This is because I am a gay man.

On April 2, 2020, the US Food and Drug Administration (FDA) amended its restriction on blood donations from gay men. They reduced the period that men who have sex with men (MSM) must abstain from sex from 1 year to 3 months to be allowed to donate. I am not celebrating. While the FDA claims that this change was in response to new data, the timing of this change is revealing. It took a global pandemic to overcome a discriminatory fear of gay blood. Yet the science shows that even 3-month of abstinence for all MSM is not needed, and these rules are putting lives at risk.

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Article Information

Corresponding Author: Greg J. Zahner, MD, MSc, Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Gray Bigelow Building 7-730, Boston, MA 02114 (gzahner@mgh.harvard.edu).

Published Online: September 8, 2020. doi:10.1001/jamainternmed.2020.4331

Conflict of Interest Disclosures: None reported.

Additional Contributions: I would like to thank Brian Custer, PhD, MPH, Jennifer Babik, MD, PhD, and Joanna Balcerek, MD, PhD, of University of California, San Francisco (UCSF), for their help in crafting this article. I would also like to thank JulieAnn McKellogg and Julia Heunis, MD for their editing guidance. They received no compensation for their contributions.

Disclaimer: The views expressed herein represent my own and do not necessarily reflect those of these individuals or of UCSF School of Medicine or Massachusetts General Hospital.

References

American Red Cross. Infectious disease, HLA and ABO donor qualification testing. Published 2020. Accessed April 2, 2020. https://www.redcrossblood.org/biomedical-services/blood-diagnostic-testing/blood-testing.html

Centers for Disease Control and Prevention. Overview: Data & Trends: Statistics US. Published 2020. Accessed April 6, 2020. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

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Anderson PL , Glidden DV , Liu A , et al; iPrEx Study Team. Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med. 2012;4(151):151ra125. doi:10.1126/scitranslmed.3004006 PubMed Google Scholar

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Cox C , Karlin J , Briggs J , et al. Open letter to FDA from medical professionals: GLAAD. 2020. Accessed August 7, 2020. https://www.glaad.org/blog/open-letter-fda-medical-professionals

Zaveri M . Doctors press FDA to let more gay men donate blood. New York Times. April 16, 2020.

Whitaker BI . The donor HIV Risk Questionnaire Study (HRQ). Blood Products Advisory Committee. Published 2019. Accessed June 19, 2020. https://www.fda.gov/media/127507/download

Kanny D , Jeffries WL IV , Chapin-Bardales J , et al; National HIV Behavioral Surveillance Study Group. Racial/ethnic disparities in HIV preexposure prophylaxis among men who have sex with men—23 urban areas, 2017. MMWR Morb Mortal Wkly Rep. 2019;68(37):801-806. doi:10.15585/mmwr.mm6837a2 PubMed Google Scholar Crossref

Busch MP , Glynn SA , Stramer SL , et al; NHLBI-REDS NAT Study Group. A new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors. Transfusion. 2005;45(2):254-264. doi:10.1111/j.1537-2995.2004.04215.x PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.