Covid: Prioritising surgery inpatients for vaccinations may save lives, study suggests

Tens of thousands of post-operative deaths could be avoided by ensuring patients are given coronavirus vaccines while waiting for elective surgery, a new study suggests.

People awaiting surgery around the globe should thus be prioritised for Covid-19 jabs ahead of other groups, according to the research, funded by the National Institute for Health Research (NIHR).

Studying data for 141,582 patients from across 1,667 hospitals in 116 countries – including Australia, Brazil, China, India, UAE, the UK and the US, scientists found that between 0.6 and 1.6 per cent of patients have developed coronavirus in the wake of elective surgery.

For patients who did contract Covid-19, their risk of death was four to eight times greater than typically seen in the 30 days after surgery.

For example, the post-operative mortality rate for cancer patients over the age of 70 is 2.8 per cent. This rose to 18.6 per cent in those who also contracted coronavirus.

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Given the higher risks that surgical patients face, scientists calculate that vaccines are more likely to have a life-saving impact upon pre-operative patients – particularly the over-70s and cancer patients – than among the general population.

The researchers estimated that – in order to save one life in the course of a year – 351 people aged over 70 facing cancer surgery required vaccination. This figure rises to 1,840 among over-70s in general.

“Pre-operative vaccination could support a safe restart of elective surgery by significantly reducing the risk of Covid-19 complications in patients and preventing tens of thousands of Covid-19-related post-operative deaths,” said co-lead author Aneel Bhangu, from the University of Birmingham.

“While vaccine supplies are limited, governments are prioritising vaccination for groups at highest risk of Covid-19 mortality,” he added. “Our work can help to inform these decisions.”

Overall, the scientists estimate that global prioritisation of pre-operative vaccination for elective patients could prevent an additional 58,687 coronavirus-related deaths in a single year.

They say this could be particularly important for low and middle-income countries, where mitigation measures are unlikely to be universally implemented.

The findings by the CovidSurg Collaborative – an international team of researchers led by experts at the University of Birmingham – were published in the British Journal of Surgery.

The Joint Committee on Vaccination and Immunisation (JCVI) has set out that in the UK, vaccines should be given to the oldest and most vulnerable members of the population first, and then continue in order of age – which it says is the single largest determinator of risk from Covid-19.

Additional reporting by PA