Your blood could save up to three lives this Giving Tuesday

Donating money isn’t the only way you can help people. You can also give your blood. Of the approximately 62 percent of Americans eligible to donate blood, only 3 percent do so each year. But someone needs blood every few seconds in the US. While the average red blood cell transfusion is about three units, a single car accident victim can need up to 100 units of blood. Key takeaways * Very few people eligible to donate blood do so each year. * The need for blood is even greater around the holiday season. Blood has a limited shelf life and is used for many medical treatments. * Efforts are underway to create synthetic blood, but it won’t replace the real thing. Consider doing your part to ensure patients get the blood they need. However, as temperatures dip and the holiday season approaches, blood donations drop off dramatically. Schools go on break, seasonal illnesses spike, and many places experience inclement weather. And New York Blood Center Enterprises (NYBCe) — a community-based blood center which, despite the name, serves over 17 states and upwards of 75 million people — regularly sees a nearly 50 percent drop in donations in the last few weeks of the year. “We know everybody’s schedules get really busy,” Diane Calmus, the vice president of government affairs at America’s Blood Centers, told me. But people “continue to have babies and can hemorrhage. Car accidents continue to happen. Cancer patients continue to need treatment.” All of these situations require a continuous blood supply. The problem is one of supply more than demand. Donor blood must be screened for diseases as well as compatibility with recipients to avoid serious — and potentially fatal — consequences. The US blood supply also relies almost entirely on an unpaid volunteer system, and for good reason, but getting enough people to donate is a difficult challenge. “We’re supplying our hospitals’ most urgent, most immediate needs,” said Chelsey Smith, the senior director of public relations at NYBCe, “but we essentially have no cushion at all when it comes to emergencies or unexpected traumas.” The Vox guide to giving The holiday season is giving season. This year, Vox is exploring every element of charitable giving — from making the case for donating 10 percent of your income, to recommending specific charities for specific causes, to explaining what you can do to make a difference beyond donations. You can find all of our giving guide stories here. But, in addition to donating blood, there are ways we can work to solve our shortage problems by loosening outdated restrictions and developing creative approaches to expand access to blood — or lab-grown alternatives. “If every single eligible person donated blood at least once a year, we would not have blood shortages in this country,” Smith said. “That’s the reality.” How blood donation works First, here’s some background on what you’re donating when you give your blood. When you picture a blood donation, you’re probably thinking of whole blood. It’s the most flexible donation type and requires the least time commitment. If you’re eligible to donate, you can do so every 56 days — up to 6 times a year. Blood is made up of four parts — plasma, white and red blood cells and your platelets. You can donate these individually, but most donations are of whole blood, which comes directly from your veins. It can be transfused as-is to a single person rapidly losing blood, or separated out into red blood cells, plasma, and platelets to help up to three people. Why I wrote this I’ve been donating on and off since I first became eligible at 17. Like many people, I learned my blood type after donating for the first time. I’m not squeamish around blood or afraid of needles, and I like knowing that something my body produces on its own is able to positively transform up to three lives. It’s a relatively easy way to do good. Like most people, I donate more often when it’s convenient. School- and workplace-based drives make it simple, but it’s a challenge to find the time to go out of my way to a blood donation center. I donated most often in college and when I worked at a hospital with a blood bank onsite, and not at all during the COVID-19 lockdown. I’ve never had much trouble post-donation, and I find the whole process fascinating. So I set out to find what does — and doesn’t — work to incentivize donors. I think I came away with more questions than answers, and learned a lot about debates within the blood banking community. And I learned a lot about blood shortages, efforts to create synthetic blood, and blood itself. Have questions, comments, or ideas? Email me: shayna.korol@voxmedia.com While there are 48 recognized blood groups, the most important for transfusion are the ones you’re probably already familiar with: A+, A-, B+, B-, AB+, AB-, O+, O-. Your blood type is genetic and determined by the antigens — substances that trigger immune reactions if they’re foreign to your body — on the surface of your red blood cells. There’s a very good chance that anyone reading this is likely O+. Outside of some countries in Europe and Asia, it’s the most common blood type in the world. About 38 percent of Americans, myself included, have O+ blood. Black and Latino Americans are more likely to be O+ than white and Asian Americans. But since there are more than 300 blood antigens, some people have extremely rare blood types like Rh null — called “golden blood” because it is so rare that there are fewer than 50 known cases in the entire world — or the Bombay phenotype, which occurs in 1 in one million people in Europe and 1 in 10,000 people in India. People with these blood types can only receive blood from others with the same type, which is a problem because there are so few donors, and you can suffer severe medical complications and even die from receiving incompatible blood. Some blood antigens are more common in people of certain ethnic backgrounds, and patients with blood disorders who receive frequent transfusions need more closely matched blood to avoid complications. Conditions like sickle cell disease and thalassemia are significantly more common in people of certain ancestries; chronically transfused sickle cell patients rely on Ro subtype blood to minimize immune reactions, which is about ten times more common in Black donors than white ones. As sickle cell patients are living longer with medical advancements, the need for Ro blood is rising by 10 to 15 percent per year. In the US and the Global North more broadly, blood donations disproportionately come from white donors. There are historical reasons for this — segregation extended even to blood from Black donors, and ethnic minorities often mistrust the medical system as a result of mistreatment. It’s critically important to recruit ethnic minority donors in ways that don’t make them feel othered, said Eamonn Ferguson, a professor of health psychology at the University of Nottingham. “I think there’s a lot of trust building that needs to be done,” Ferguson told me. “The blood donor pool should represent the demographics of a country.” A labyrinth of donation rules If you’ve ever donated blood before, it was very likely through a Red Cross drive. The American Red Cross collects about 40 percent of the American blood supply. The rest comes from independent community-based blood centers, hospital blood banks, and a small amount of imports. Besides having to screen for blood type compatibility, there are a bunch of other bureaucratic rules — some well-founded, and others dated — that curb the number of possible donors. To understand where they come from, we’ll take a quick detour into history. The US Army established the first blood banks on the Western Front in World War I. Until World War II, nearly all transfusions were of whole blood, which had a short shelf life. But after the discovery of the Rh blood group system and the creation of the first blood container in 1940, the US launched a national blood collection program that relied heavily on paid donors for its supply. That same year, Charles Drew — the African American researcher who developed a process to break down and store plasma — spearheaded the “Blood for Britain” project, sending thousands of plasma donations from the US to British soldiers on the frontlines. Drew’s work paved the way for transfusing blood components in addition to whole blood, vastly improving the field of transfusion medicine. For several decades, blood banks relied mostly on paid donors to meet their needs, which meant that it was disproportionately the poorest members of society who gave blood. This included people with drug habits who contracted hepatitis from contaminated needles, putting transfusion recipients at high risk of contracting the disease themselves. So, in response to these safety concerns, the FDA required all blood intended for transfusion to be labeled paid or volunteer in 1978. Paid donations didn’t become illegal, but hospitals were incentivized to shift to volunteer donations for safety and liability reasons. With the exception of the plasma market — a multibillion-dollar industry, with the US providing about 70 percent of plasma used worldwide — the American blood supply now effectively relies entirely on unpaid volunteers. According to the World Health Organization, the gold standard for a safe and reliable blood supply is unpaid voluntary donations, but 54 countries still rely on paid or family donors for more than half of their blood supply. Donors who receive payment or provide donations intended for specific family members are not always incentivized to be truthful about their medical histories out of desperation. And non-volunteer systems have a history of negligence and exploitation. The Arkansas prison blood scandal, in which the state sold plasma extracted from prisoners, led to blood contaminated with hepatitis and HIV being knowingly sent to blood brokers, who then shipped it all over the world, leading to thousands of infections and deaths. The HIV/AIDS crisis also posed a tremendous challenge to the blood system. Before there was a reliable way to screen for the virus, people with hemophilia and other bleeding disorders were at high risk of contracting the disease from donor blood. Directed donations to family members became popular during this time, said Claudia Cohn, the medical director at the University of Minnesota Medical Center Blood Bank. But the need for this went down when HIV testing became available in 1985. That year, the FDA banned men who have sex with men from donating blood for life due to the mistaken belief that HIV was a “gay disease.” Other high-risk groups, like intravenous drug users and sex workers, were only temporarily banned from giving blood for a year. The FDA relaxed the restrictions on donations from gay and bisexual men in 2015, but only if they stopped having sex for a year before donation. It only fully lifted the lifetime deferral in 2023, moving instead to a risk assessment based on individual donor behavior rather than sexual orientation. The challenge of motivating donors Getting people to donate isn’t easy. It’s hard when you’re busy to go out of your way to a donation site. And so making donation more convenient for volunteer donors is crucial. I, for one, have mostly donated through school- or workplace-based drives. Even then, giving your blood takes time. After registration, donors undergo a health screening that measures their pulse, blood pressure, and hemoglobin levels. You’ll also be asked questions about your health and travel history, and you may be deferred if you’ve recently traveled to a place where bloodborne infections like malaria are common. Most deferrals are not permanent, but many people do not return after being turned away. I’ve been deferred several times for slightly-too-low hemoglobin levels, which naturally fluctuate and are often lower in people who menstruate. The Red Cross recommends eating iron-rich foods before donation, and asks frequent donors to consider taking an iron supplement. Some people are afraid of needles, and there’s no way to get around that for a blood draw (although I can attest that it doesn’t really feel like more than a brief pinch, and the needles are safe, single-use, not that big, and clean). ImpactLife, a nonprofit blood provider serving more than 130 hospitals and emergency medical service organizations in the Midwest, recently stopped using the standard finger prick to provide a drop of blood for pre-donation screening, instead using pain-free OrSense technology to measure a prospective donor’s hemoglobin level through their skin. Kirby Winn, the manager of public relations at ImpactLife, told me over email that first-time donors especially will “have a slightly more positive experience without the finger prick. We’re excited to see if that will result in any increase in donor retention rates over the long term.” Blood centers always seek new donors, because repeat donors can lose their eligibility to donate if their health changes. But they do try to tap repeat donors often. The American Red Cross once left me four voicemails in a single day. I guess that strategy works, since I’m a semi-regular whole blood donor — “part of the whole blood community,” as one voicemail put it. According to American Red Cross spokesperson Rodney Wilson, approximately 90 percent of individuals who show up for appointments do so because of direct-to-donor marketing efforts. “Our outreach ensures donors understand the critical role they play in patient health outcomes and motivates them to schedule an appointment,” Wilson said. Blood centers don’t pay people for blood used for transfusions in the US, but that doesn’t mean there are no gift incentives. Maybe you’ve gotten messages asking you to donate blood before a certain date to receive an e-gift card, clothing item, or chance to win a vacation package. [Image: Vials of blood during the 28th blood donation marathon at the Ramon y Cajal Hospital, on November 19, 2025, in Madrid, Spain. https://platform.vox.com/wp-content/uploads/sites/2/2025/11/gettyimages-2247436283.jpg?quality=90&strip=all] There’s evidence that younger generations are more incentivized by gifts to donate blood than by pure altruism. And there’s a desperate need to recruit younger donors — about 60 percent of US donations come from donors over the age of 40. Youth donation rates fell off steeply during the COVID-19 pandemic as schools and colleges closed, and they haven’t recovered to pre-pandemic levels. It’s a troubling trend, Cohn told me, because blood centers often depend on high school blood drives for their supply. “The donor pool is shrinking,” Philip Spinella, a co-director of the Trauma and Transfusion Medicine Research Center at the University of Pittsburgh, told me. “In 10 to 15 years, we’re going to be in a very bad place because the [donor] population is aging.” And while there are certainly ethical questions around gift and financial incentives, we pay for plasma to create life-saving therapies. The US is a mass exporter to countries that don’t do this, enabling more people to get the plasma they need. And it turns out that the viral Red Cross x Snoopy merch campaign from 2023 worked: during the first week, the Red Cross saw 14,000 first-time donors — mostly people under the age of 34 — and a 40 percent increase in blood donation appointments. Solving our shortage problems Worldwide, millions die preventable deaths each year due to a lack of access to blood transfusions, and the situation is particularly dire in the Global South. It’s a significant problem in the US too: between 30 to 40 million Americans live more than an hour away from a major trauma center, and only 1 percent of emergency medical service (EMS) agencies carry blood with them. One study estimates that over 20,000 deaths could have been prevented over a four-year period if EMS agencies had universal access to prehospital blood for transfusion. “There’s just a huge swath of the United States and the [entire] world that is at tremendous risk from dying from lack of [access to] transfusion,” Nakul Raykur, a trauma surgeon at Brigham and Women’s Hospital and the chair of the Blood D.E.S.E.R.T Coalition, told me. So what about loosening outdated restrictions? Restrictions are in place to protect donors and recipients, but they can unnecessarily narrow the donor pool. It’s a start that, in recent years, the FDA has shifted to an individual risk-based assessment. How to donate your blood — and how to help if you can’t Everyone has a role to play. “Whether you’re advocating for blood donors, whether you’re telling stories of how blood is used and educating the population on the importance of blood donation, or whether you’re a blood donor yourself, all of these are incredibly important,” Linda Barnes, a consultant and expert in blood donation, told me. Check your eligibility. You might be surprised to find that there are relatively few medications that make people ineligible to donate blood. If you donate successfully, you’ll find out your blood type. If you can donate blood: Find a blood drive or collection center near you. Sign up for a time to donate that works well for you. Stay hydrated, eat healthy iron-rich foods before donation, and bring a photo ID and list of medications. Try to arrive 15 minutes early so you don’t feel rushed through the registration process. Wait for your name to be called and sit through the health screening. Then get ready to roll up your sleeve and donate. Some people like to listen to music or watch movies during the donation. Afterwards, help yourself to some refreshments. The cookie selection is usually pretty decent. Drink extra (non-alcoholic) fluids, and avoid heavy lifting for the rest of the day. If you’re not feeling well or experience problems after the donation, you can contact the blood collection center and let them know. If you can’t (or want to help in other ways): You can volunteer to coordinate blood drives, checking in donors and manning the post-donation refreshment station. You can also become a volunteer driver to deliver blood. Follow the work of organizations like the Blood D.E.S.E.R.T. Coalition. Reach out to your Congressional representative and ask them to support H.R. 5791, the bipartisan Boosting Lifesaving Operations, Opening Donation (BLOOD) Centers Act. This would streamline the licensure process for new blood centers. You can also make financial contributions to blood collection centers like New York Blood Center Enterprises and ImpactLife to enable them to perform their lifesaving work. Follow the work of organizations like the Blood D.E.S.E.R.T. Coalition. Encourage your friends and family who may be eligible to donate blood to do so, and share articles like this one that talk about the need for blood donation. And in 2022, the FDA lifted a ban in place since 1980 on donations from people who spent long periods of time in European countries affected by “mad cow” disease, potentially expanding the donor pool by hundreds of thousands. But there are still restrictions on what blood donations from women who have been pregnant and developed antibodies to human leukocyte antigens (HLAs) can be used for. HLA antibody-positive women can still donate red blood cells, but their whole blood, plasma, and platelets won’t be transfused because they can cause a severe complication in transplant recipients. Efforts are underway to remove those antibodies from the blood so that their plasma, platelets, and whole blood could still be used, increasing the reach of their donations. Since many donors are motivated by altruism, it stands to reason that they’d be motivated by double altruism, where a donation organization provides a charitable gift on a donor’s behalf just for turning up. The idea, Ferguson told me, is that this could ease the sting of being turned away and encourage prospective donors to try again. More blood banks could proactively engage donors by telling them where or how their donation was used. This is something I’ve always wondered about my own donations. Scientific advances can make the blood supply even safer — virtually eliminating the risk of bloodborne infections from transfusion using pathogen reduction technology — and help it go farther. Trials to significantly extend the shelf life of blood components have shown tremendous promise. But there is still more we can do. “The 1950s was the last meaningful advance in blood collection and storage,” when plastic bags replaced glass bottles for blood collection, said Allan Doctor, a professor of pediatrics and the director of the Center for Blood Oxygen Transport and Hemostasis at the University of Maryland School of Medicine. “It’s outdated technology.” Delivering blood by drone can help get around geographic barriers to transfusion access in low- and middle-income countries and the US, Raykur told me. And walking blood banks — a military strategy where blood is screened using rapid diagnostic tests and quickly transfused when there is no access to lab-screened blood in time — could be used in more non-military settings like cruise ships. And coolest of all, we can invest time and resources into helping synthetic blood take off. Synthetic blood is one of the “holy grails” of medical research, with the potential to help end shortages, revolutionize treatment for blood disorders, and provide alternatives to people who refuse donor blood transfusions on religious grounds. It could save a lot of lives. Keith Neeves, a professor of bioengineering and pediatrics and the scientific director of the Hemophilia and Thrombosis Center at the University of Colorado Anschutz, told me that there are two main approaches to making lab-grown blood. The “biologists’ approach” involves coaxing stem cells into becoming fully-fledged blood cells, and the “chemists’ approach” uses bioengineering and materials science methods to create synthetic cells. Neeves thinks the chemistry-based approach is further along — it’s the one largely backed by the Department of Defense, which is very interested in synthetic blood to tackle hemorrhage, the number one cause of battlefield deaths. And chemistry-based approaches can provide blood products in powdered form and don’t require a complex cold chain, although stem cell approaches may be ideal for rare blood types. One example of this approach in action is a biotech startup founded by Doctor, from the University of Maryland School of Medicine, and Spinella called KaloCyte, which is developing a dried artificial red blood cell called ErythroMer. “Soldiers will carry it. It’ll be on the space station. It’ll be on cruise ships, you know, it’ll be in warehouses in case of mass casualty incidents,” Doctor speculated in a recent interview with Vox. Synthetic blood products could offer an alternative for resource-limited settings with high rates of bloodborne diseases and a lack of blood banking infrastructure. He thinks it will be commercially available within two decades — if all goes well with human clinical trials. Some people think synthetic blood will replace donor blood, Doctor said, but it won’t. “It’s intended to fill a gap where blood can’t go,” he told me. “It extends the ability to do transfusions in environments where we currently can’t. If you’ve got synthetic blood and you’ve got natural blood in a hospital, there are very, very few circumstances where you would choose the synthetic blood first.” Donors won’t be out of a (volunteer) job. People give all sorts of reasons why they don’t donate, often based on misconceptions about the process, but “the number one reason people don’t donate is because they weren’t asked,” Raykur said. So consider this an ask.