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A woman in Colorado has been refused a kidney transplant because she has not had a COVID-19 vaccine, according to a document shared online.

Leilani Lutali shared with US media a letter she received from the UCHealth Transplant Center near Denver, which stated she would be removed from the transplant list unless she begins the vaccine process within 30 days.

The letter, which was also shared on Twitter by state representative Tim Geitner, said the patient would be placed as “inactive” on the transplant waiting list for “non-compliance by not receiving the COVID vaccine”.

The letter reads: “The transplant team at University of Colorado Hospital has determined that it is necessary to place you inactive on the waiting list.

“You will be inactivated on the list for non-compliance by not receiving the COVID vaccine. You will have 30 days to begin the vaccination series.

“If your decision is to refuse COVID vaccination you will be removed from the kidney transplant list.

“You will continue to accrue waiting time but you will not receive a kidney offer while listed inactive.”

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Speaking to CBS News, Ms Lutali , who has stage five renal failure, said she has not taken the vaccine because there are too many unknowns.

She said she only found out that the hospital was now requiring both herself and the donor to be vaccinated on 28 September.

“It’s surgery, it’s invasive. I sign a waiver for my life. I’m not sure why I can’t sign a waiver for the COVID shot,” she said.

Her donor Jaimee Fougner, who received the same letter from UCHealth, told the broadcaster she has not received the vaccine for religious reasons.

Ms Fougner said: “It’s your choice on what treatment you have. In Leilani’s case, the choice has been taken from her. Her life has now been held hostage because of this mandate.”

The women have said they are now looking for another hospital to perform the transplant but have yet to find one.

UCHealth told Sky News in a statement that its priority is to “provide excellent, safe care for transplant patients before, during and after a transplant surgery”.

“An organ transplant is a unique surgery that leads to a lifetime of specialised management to ensure an organ is not rejected, which can lead to serious complications, the need for a subsequent transplant surgery, or even death.”

“Physicians must consider the short- and long-term health risks for patients as they consider whether to recommend an organ transplant,” it added.

“In almost all situations, transplant recipients and living donors at UCHealth are now required to be vaccinated against COVID-19 in addition to meeting other health requirements and receiving additional vaccinations.”

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Defiant Biden attacks Trump but admits ‘I don’t debate as well as I used to’

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Defiant Biden attacks Trump but admits 'I don't debate as well as I used to'

Joe Biden has attacked Donald Trump at a rally a day after the president’s “shocking” performance in a head-to-head debate.

“I don’t walk as easy as I used to, I don’t speak as smoothly as I used to, I don’t debate as well as I used to but I know what I do know,” said President Biden. “I know how to tell the truth.”

His performance in the debate against Trump on Thursday night was described as an “unmitigated disaster” by some in his own party after he paused and stumbled his way through, prompting calls for him to step down.

“I give you my word as a Biden, I wouldn’t be running again if I did not believe, with all my heart and soul, I can do this job,” he told the rally in North Carolina.

Mr Biden attacked the former president’s criminal record, calling Donald Trump a “one-man crimewave”.

President Biden greets supporters as he arrives in Raleigh. Pic: AP
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President Biden greets supporters as he arrives in Raleigh. Pic: AP

“My guess is he set a new record for the most lies told in a single debate,” he added, telling the crowd he spent “90 minutes on the stage debating a guy with the morals of an alley cat”.

Donald Trump at rally in Virginia after debating President Joe Biden
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Donald Trump at rally in Virginia after debating President Joe Biden

Hours later, Donald Trump was jubilant at a rally in Chesapeak, Virginia.

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“Never mind that crooked Joe Biden spent a week at Camp David, resting, working, studying – he studied so hard he didn’t know what the hell he was doing,” said Mr Trump to the crowd.

“Biden’s problem is not his age, […] he’s got no problem other than his competence. He’s grossly incompetent,” he added.

Bad debate nights happen

Barack Obama tweeted his support for President Biden on Friday evening, saying: “Bad debate nights happen. Trust me, I know.”

But others remained unconvinced Joe Biden should run for president.

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Joe Biden appears to stall during debate

“I do not think President Joe Biden can be the Democratic Party’s standard-bearer in 2024,” former White House director of global engagement Brett Bruen told Sky News’ Yalda Hakim.

“Last night’s performance was astonishingly bad. You cannot just be strong on the teleprompter,” he said.

But Anthony Scaramucci, former White House communications director, blamed the president’s poor performance on his preparation.

“He wasn’t prepped right for that debate. He’s an older man,” Mr Scaramucci told Yalda Hakim.

“You don’t fill his head with facts and figures he’s never going to remember.”

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Biden v Trump: What you need to know

There have been repeated calls for President Biden to step down.

It’s “time to talk about an open convention and a new Democratic nominee,” one Democratic politician told Sky’s US partner network NBC News.

Read more from Sky News:
Joe Biden: Could the Democrats replace him as US election nominee?

Biden performance against Trump was among worst in presidential history

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Kamala Harris says Biden had a ‘slow start’ but he ‘pushed facts’ while Donald Trump ‘pushed lies’.

However, while Vice President Kamala Harris acknowledged that President Joe Biden had a “slow start” in the debate, she insisted that he finished “strong”.

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At a Waffle House restaurant in Atlanta after the debate, Biden told reporters he did not have concerns about his performance. “It’s hard to debate a liar,” he said.

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Joe Biden: Could the Democrats replace him as US election nominee and how might that work?

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Joe Biden: Could the Democrats replace him as US election nominee and how might that work?

Joe Biden’s stumbling performance in the US presidential debate has sparked alarm among Democrats – but could he be replaced against his will and how might that work?

A national US party has never tried to force an election candidate to step down in the modern era and their rules make it almost impossible to do so.

Latest: Reaction to Biden v Trump debate

The issue came before both parties in 2016, but neither took action and there’s currently no known effort to force Mr Biden to give way.

It would mean Democrat officials overturning the results of the state primaries – the votes that took place earlier this year that confirmed Mr Biden as the overwhelming pick for November’s election.

The 81-year-old won virtually all the delegates – and they are now set to go through the customary process of rubberstamping his nomination at the Democratic National Convention in August.

There are ways to replace a nominee if they die, resign or are incapacitated, but forcing Mr Biden out would mean delegates choosing another candidate.

It appears highly unlikely, as they were chosen in the primaries because of their loyalty to the president and with the trust that they would vote for him at the convention.

Read more:
‘Unmitigated disaster’ for Biden in TV debate with Trump
Key moments from Trump v Biden

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Biden v Trump: Highlights from the debate

However, there is a potential “loophole” in that Democrat rules allow them to “in all good conscience reflect the sentiments of those who elected them”.

So if concerns about his performance and mental acuity reach critical level this could be a way forward.

Watch a special programme with reaction to the US presidential debate on The World with Yalda Hakim on Sky News from 6pm

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Biden appears to stall during debate

What if Biden withdraws himself?

This is the only plausible scenario for the Democrats to choose a new candidate to take on Donald Trump.

Mr Biden has repeatedly dismissed this option during other turbulent times, but if he changed his mind he could simply serve out the remaining months of his presidency.

Such a U-turn would create a frenzy among Democrats as there’s no protocol in place for him or the party to choose a new candidate before August’s convention.

Read more:
Excruciating Biden performance was among worst ever

It takes a majority of the party’s 4,000 or so delegates to win the presidential nomination – and Mr Biden secured about 3,900 of them in the primaries.

The president would have some influence over his pledged delegates, but ultimately they can vote as they please – so it could become a ‘free for all’ with candidates campaigning aggressively to win them over.

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Kamala Harris says Biden had a ‘slow start’.

If the president decides to pull out after the convention takes place, the chair of the party can call a special meeting of around 500 members.

They can – in theory – choose a new nominee via a simple majority vote.

However, such a process would likely be far more turbulent with behind-the-scenes jockeying and public campaigning.

If Mr Biden withdrew even closer to the 5 November election, it could raise constitutional, legal and practical concerns.

For example, voting papers have to be printed well in advance and it might not be possible to change them in time.

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Would vice president Kamala Harris replace Biden?

If Mr Biden were to resign immediately as president, Kamala Harris would automatically succeed him – but would not also become Democratic nominee.

She might be politically favoured if he ditched his re-election bid, but Mr Biden’s delegates would not transfer to her as of right, and it would be a level playing field with the other hopefuls.

Who could be favourite if Biden steps back?

Two frontunners – if they chose to put themselves forward – could be California governor Gavin Newsom, 56, or Michigan governor Gretchen Whitmer.

They didn’t enter this year’s primaries but have both been talked about as potential Democrat nominees in future.

For now at least, Mr Newsom appears to be sticking firmly behind the president.

Gavin Newsom (right) is often talked about as a potential future nominee. Pic: AP
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Gavin Newsom (right) is often talked about as a potential future nominee. Pic: AP

He told reporters after Thursday’s debate his party “could not be more wholly unified behind Biden” and he shouldn’t step aside.

Mr Newsom has been California governor since 2019 and was also San Francisco’s mayor for seven years. Before that, he founded a winery in the state’s upmarket Napa Valley.

Ms Whitmer, a lawyer and former prosecutor, was the Senate’s first female Democratic leader and became governor in 2018.

The 52-year-old also served as co-chair of Joe Biden’s 2020 election campaign.

Gretchen Whitmer has been talked about as a possible future presidential candidate. Pic: Reuters
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Gretchen Whitmer has been talked about as a possible future nominee. Pic: Reuters

She’s previously said she would have no interest in replacing Mr Biden in this year’s election – and backed him again on Friday.

“Joe Biden is running to serve the American people. Donald Trump is running to serve Donald Trump,” she said.

However, if the president pulls out of his own volition, could she change her mind?

Democrats including Minnesota’s Dean Phillips and Jason Palmer, who actually beat Mr Biden in American Samoa, might also try their hand.

They were his main rivals in the primaries but only got a couple of delegates each, so would likely struggle to pull in enough support.

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Can Joe Biden carry on?

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Can Joe Biden carry on?

Joe Biden and Donald Trump faced off in the first election debate of this year’s US presidential campaign on Thursday night.

The president was seen to mumble and stumble his way through, while Mr Trump repeated false claims that the 2020 election was rigged.

On this episode, Niall Paterson unpicks the debate between the senior citizens – with our US correspondent James Matthews in Georgia on the hits and misses, and pollster Scarlett Maguire on how American voters are feeling about the upcoming election.

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Producer: Soila Apparicio
Editor: Philly Beaumont

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