PIG Meeting: 18th March 2021

With the rollout of COVID vaccine across the community, it is likely that patients presenting to the Preoperative clinic will be potentially having vaccine around time of surgery.

Discussion

• It seems reasonable to plan for patients who will have questions about vaccination in perioperative period.
• There are guidelines around vaccination and surgery. This is usually an issue for paediatric practice (See summary of guidelines below and attached paper).
• There is a recent paper published by the Royal College of Surgeons in the UK to provide guidance for patients having COVID vaccine in the UK (see attached paper).
• The main issue to consider is 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.

Plan

• The following recommendations will be discussed with the surgical services team and be distributed to surgeons, anaesthetists and admissions staff:
  • 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.
  • We recommend 5 days between vaccination and elective surgery.
  • Vaccination can take place after surgery as soon as patient has recovered.