Using COVID-19 Vaccines in people with recent or imminent elective surgery

Eimear Maguire, Senior Medicines Information Pharmacist, North West Medicines Information CentrePublished Last updated See all updates

Information to support decision making around timing of COVID-19 vaccine administration in relation to surgery

Further advice

Public Health England’s Immunisation Against Infectious Disease (the Green Book) states in chapter 6 that recent or imminent elective surgery is NOT a contraindication to routine immunisation; however, in some of these situations, additional precautions may be required, and to refer to the relevant chapter for further information.

There is no information in chapter 14a, COVID-19-SARS-CoV-2, regarding use of the vaccine in people with recent or imminent elective surgery.

The Green Book advises that minor illnesses without fever or systemic upset are not valid reasons to postpone immunisation. If an individual is acutely unwell (for example, following elective surgery), immunisation may be postponed until they have fully recovered. This is to avoid confusing the differential diagnosis of any acute illness (including COVID-19) by wrongly attributing any signs or symptoms to the adverse effects of the vaccine.

The Royal College of Surgeons of England advises in their Vaccinated patients guidance that:

  • 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 formally agreed government / national policy for prioritising patients scheduled for elective procedures to be vaccinated before the planned operation date. However, if the vaccine is available for surgical patients within your hospital / region, RCS England strongly encourage this to take place to minimise the reported risks to patients of COVID-19 postoperatively.

Change history

  1. Added that the RCS England strongly encourage vaccination of elective patients preoperatively where available, to minimise risk postoperatively.
  1. Information from the Royal College of Surgeons of England added
  1. Published