Blood donation eligibility is governed by strict screening protocols. These rules assess a person’s medical history, current health, and travel or residence history outside of the United States. Specific regions and time periods trigger mandatory screening questions or temporary deferrals to mitigate the risk of transmitting certain infectious diseases and ensure the continued safety of the national blood supply.
The Historical Basis for Geographic Exclusion
The initial restrictions on European residents stemmed from a health crisis known as Bovine Spongiform Encephalopathy (BSE). This neurodegenerative condition in cattle became a public health concern in the 1980s. Eating contaminated beef products was linked to the development of variant Creutzfeldt-Jakob Disease (vCJD) in humans, a fatal brain disorder. Since vCJD has a long incubation period and no reliable screening test for blood, regulatory bodies worldwide implemented precautionary deferral policies. These rules aimed to prevent the theoretical risk of transmitting the disease through a blood transfusion. Germany and much of continental Europe were included in this geographical exclusion zone due to the potential presence of BSE within their food supply chain during that time.
Current Eligibility Status for German Residents
The indefinite deferral for living in Germany and Europe has been significantly updated, making most individuals who lived there now eligible to donate. The U.S. Food and Drug Administration (FDA) revised its guidance in 2022, eliminating the primary geographic deferral related to vCJD risk. This policy change was based on data showing the risk of transfusion-transmitted vCJD is negligible.
The initial broad deferral applied to individuals who had spent five years or more cumulatively in European countries between 1980 and 2020. This restriction has been removed, meaning civilian residency in Germany during that period no longer results in an automatic deferral. Those previously deferred for this reason may now be eligible to donate.
An earlier change occurred in 2020 for military personnel and their families stationed abroad. The FDA lifted the deferral for those who resided on U.S. military bases in Germany, Belgium, and the Netherlands for six months or more between 1980 and 1990. This specific deferral was removed after data indicated there were no reported cases of vCJD associated with time spent on these military bases. If you were deferred based on vCJD-related European residency, contact your blood center for a review of your eligibility status.
Other Geographic Screening Requirements
Even with the elimination of the vCJD-related European deferral, other geographic factors still influence blood donation eligibility. The most common is residency or travel to areas where malaria is considered endemic. Malaria is transmitted by mosquitoes and can be passed through a blood transfusion, and no sensitive test is routinely available for screening all donations.
If you have traveled to a malaria-endemic area, a temporary deferral of three months is required after your return. A longer deferral is applied to individuals who formerly lived in a country where malaria is common. If you previously resided in an endemic country, you must have lived in a non-endemic country for three consecutive years without returning to a malaria-risk area to be eligible. These areas include parts of Africa, Asia, and Central and South America. The screening process will include specific questions about your travel dates and location details to ensure the continued safety of the blood supply.