Royal College of Surgeons in Ireland
SARS-CoV-2 vaccination modelling for safe surgery to save lives.pdf (209.99 kB)

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

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journal contribution
posted on 2023-09-21, 13:13 authored by Dmitri Nepogodiev, Joana FF Simoes, Elizabeth Li, Maria Picciochi, James C Glasbey, Aneel Bhangu, GlobalSurg Collaborative, COVIDSurg Collaborative, Sami Abd Elwahab, Niall DavisNiall Davis, Mohsen JavadpourMohsen Javadpour, Brendan McdonnellBrendan Mcdonnell, Paula Corr, Lauren Crone, Johnathon Harris, Arnold HillArnold Hill, David Kearney, Robert Anthony Keenan, Deirdre Nolan, James Ryan, Carmen ReganCarmen Regan, Michael GearyMichael Geary, Fergal MaloneFergal Malone

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.

Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty.

Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year.

Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.

Trial registration: NCT04509986.


National Institute for Health Research (NIHR) Global Health Research Unit grant (NIHR 16.136.79) using UK aid from the UK government to support global health research

Association of Coloproctology of Great Britain and Ireland

Bowel & Cancer Research

Bowel Disease Research Foundation

Association of Upper Gastrointestinal Surgeons

British Association of Surgical Oncology

British Gynaecological Cancer Society

European Society of Coloproctology

NIHR Academy

Sarcoma UK

The Urology Foundation

Vascular Society for Great Britain and Ireland

Yorkshire Cancer Research



The original article is available at

Published Citation

COVIDSurg Collaborative, GlobalSurg Collaborative. SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study. Br J Surg. 2021;108(9):1056-1063.

Publication Date

24 March 2021

PubMed ID



  • Obstetrics and Gynaecology
  • Beaumont Hospital
  • Otolaryngology Head and Neck Surgery
  • Surgery

Research Area

  • Surgical Science and Practice
  • Cancer


Oxford University Press (OUP)


  • Published Version (Version of Record)