Vaccinated patients guidance
- Date published: 24 December 2020
- The text below has been taken from the original PDF for ease of use. Download the original
For surgeons and surgical teams managing vaccinated patients
With the Pfizer COVID-19 vaccination now available for selected individuals, and a good safety profile documented, the UK Surgical Royal Colleges have been advised the following :
- the vaccine may give some systemic events, such as a fever and chills, within 1-2 days after vaccination, but these resolve soon after. It is reported normally to settle fully within a week.
- such a fever is uncommon after dose 1, but occurs in about 15% after dose 2. A more detailed description of local and systemic side effects following vaccination are detailed in the NEJM reference attached.
- essential urgent surgery should take place, irrespective of vaccination status.
- non-urgent elective surgery can also take place soon after vaccination. There is some rationale for separating the date of surgery from vaccination by a few days (at most 1 week) so that any symptoms such as fever might be correctly attributed to the consequences of either vaccination or the operation itself.
- at present, there is no policy established for prioritising patients scheduled for elective procedures to be vaccinated before the planned operation date. However, if the vaccine is available for this cohort of patients, then this would not be a reason for it to be withheld.
The UK Surgical Royal Colleges have adopted the combined AoMRC statement on vaccination for health professionals, which urges that surgeons and their teams ‘should’ take up vaccination when offered it, unless there are medical reasons why they should not (such as specific allergies, participation in vaccine trials). Such vaccination is not mandated however under current guidance from the DHSC and CMO
- This guidance will be reviewed regularly, and additional vaccines, when licensed for use, will be similarly evaluated.
Your operation and COVID-19 Vaccination
This information is provided by the UK Surgical Royal Colleges, using advice from all medical authorities and the NHS England Director for Immunisation as well as the Head of Immunisation for Public Health England.
If you are about to undergo an operation, this information is to support you if you have had, or are considering, vaccination against the COVID-19 virus.
- all advice is that there is no reason for you not to undergo all forms of surgical intervention, including the use of general anaesthesia, if you have received the Pfizer vaccine.
- after the first dose of vaccination, some patients uncommonly develop a fever or chills, which may last, at most, for a week.
- after the second dose of vaccine, about 1 in 6 (15%) of patients will develop a fever, which again should settle (usually) rapidly within the first 48 hours, but at most up to a week.
There is no information available to suggest that your operation will be any less safe than it would normally be if it is done at any time during this period. You should, however, have taken all usual precautions against becoming infected with the virus before your planned surgery, since vaccination is not complete until the 4 week process has ended.
However, because a fever might be confusing for the team managing you to understand whether it relates to the vaccine or your operation, it is may sometimes be the case that a non-urgent operation will be delayed by (at most) a week following vaccination, simply to allow the symptoms to settle fully.
There are likely to be more versions of vaccine available soon, and when these are available, the Royal Colleges of Surgeons will evaluate the guidance again and issue revised guidance.
Professor S Michael Griffin, President RCSEd
Professor Neil Mortenson, President RCSEng
Professor Jackie Taylor, President RCPSG