(P-BC-17) Blood Donor Return Behavior in South Africa and the United States Before and During the COVID-19 Pandemic.

We analyzed 2017-2022 visits by whole blood donors in South Africa (SA) and the United States (US) stratified by pre-COVID-19 (until 29 February 2020) and intra-COVID-19 period (beginning 1 March 2020), mobile and fixed environment, and first-time and repeat donor status. We used Kaplan-Meier curves to characterize time-to-return after completed donation, hemoglobin deferral, and other temporary deferral; we used cumulative incidence functions to analyze switching between donation environments; and we used Cox proportional hazards models to analyze factors influencing time-to-return.  

Results/Findings: Pre-COVID-19: Overall time-to-return was shorter in SA. The proportion of donors returning within a year of becoming eligible was lower after deferral than after completed donation in both countries regardless of donation environment and deferral category (Figure A). Intra-COVID-19: For all donor categories, the gap in time-to-return between deferred and non-deferred donors widened in the US but narrowed in SA. In SA, the proportion of deferred first-time donors returning within a year increased to >81% for both deferral categories in both environments, exceeding the proportion returning within a year for first-time donors after completing a donation (80% at fixed sites; 69% at mobile drives). 

Conclusions: The pandemic complicated efforts to recruit new donors and schedule returning visits after completed donations in both countries. Concerted efforts to improve time-to-return for deferred donors in SA narrowed the gap in time-to-return for deferred vs. non-deferred donors, particularly for first-time donors. Improving return of deferred donors is feasible and can help prevent blood shortages