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

BACKGROUND AND OBJECTIVES: Requests for "unvaccinated" blood have been discouraged by professional and regulatory bodies because they lack scientific support and may negatively impact patient care. We describe a single-center series in which patients or surrogates refused standard blood components unless sourced from directed donors perceived to be "unvaccinated." MATERIALS AND METHODS: We performed a retrospective review of directed donations received at Vanderbilt University Medical Center between January 1, 2024 and December 31, 2025. Data included demographics, clinical scenario, component details, and documented operational or clinical consequences. RESULTS: Directed donor units were received for 15 patients; 13 of these patients were transfused at least one unit (n = 31 directed components: 22 red blood cell [RBC] units, 5 platelet units, 2 plasma units, 2 cryoprecipitate units). Median age was 17 years (range 0.33-73); nine patients were pediatric (