American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Talk It Up Surgeon Guide

Have a conversation with your patients about COVID-19 vaccination

As surgeons, having difficult conversations with our patients is part of the job. Now we need your help in starting a new conversation: speaking with your patients about being vaccinated against COVID-19.

The American College of Surgeons has considered some frequently asked questions you may be getting from your patients. We realize that due to local issues, giving a uniform answer to these questions is not entirely possible. However, we hope you use this document as a guide and verify the information on a state and local level as well as with your hospital as you prepare to Talk It Up! with your patients.

#TalkItUp | It's very important.

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NOTE: Review these suggested responses, but please keep in mind that all requirements and regulations should be verified on a local level with your institution.

conversation starter

Surgeon: My interest is in providing you with current scientific information about COVID-19 so you can accurately make the best decision for yourself.

1. Potential vaccination questions from patients

Q: Why do you recommend that your patients get vaccinated?

A: Because it's the safest and most effective way for patients to protect themselves from getting COVID-19. Wearing masks and social distancing do cut down on spreading the virus. But those methods may not fully protect you if you're still exposed to it. Vaccination alone prepares your immune system to fend off the virus.

Plus, vaccination is an important step that will keep your immune system focused on recovering from your operation. I don't want to worry about you recovering from surgery and also battling COVID at the same time. You may be exposed to it once you leave the hospital to recover at home. And I really don't want to see you readmitted to the hospital with COVID during your recovery when I discharged you COVID-free to go home and get well.

Q: Do you think the COVID-19 vaccine is safe?

A: COVID-19 vaccines are safe and effective. In fact, I've been vaccinated and my family has been too. The FDA has approved the first vaccine to prevent COVID, the Pfizer-BioNTech COVID-19 Vaccine, in those 16 years of age and older. Emergency authorization remains in place for those 12-15 years old. It's been reported that the Moderna vaccine is currently undergoing the FDA approval process, and Johnson & Johnson will seek approval soon. Like the Pfizer the vaccine, the latter two were evaluated in tens of thousands of participants in clinical trials and met the FDA's rigorous standards to support emergency authorization. Since then, millions of people in the U.S. and worldwide have been vaccinated. All COVID-19 vaccines continue to undergo intensive monitoring to ensure continued safety.

Q: I'm healthy and in good shape. Since I rarely get sick, why do I need to get vaccinated?

A: The effects of COVID-19 are unpredictable. Even in young and healthy people, the symptoms of COVID can be severe or long lasting. Vaccination ensures you are protected from severe illness due to COVID. Further, being vaccinated helps those around you by reducing the spread of COVID within your household, your workplace, and in your community.

Q: Can vaccinated patients with no symptoms still spread COVID?

A: Yes, but a vaccinated patient is less likely to spread COVID than an unvaccinated patient.

Q: If you recover from COVID, do you still need to get vaccinated?

A: Yes, you should get vaccinated regardless of whether you have already had COVID-19. Experts are unsure how long you are protected from getting sick again after recovering. Studies have shown that vaccination provides a strong boost in protection in people who have recovered from COVID.
If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine.

Q: Should I get a booster vaccination?

A: A COVID-19 booster dose is recommended for those with compromised immune systems. For others, federal health officials have a plan to begin offering a vaccine booster in fall 2021, pending final FDA evaluation of third doses.

Q: How likely am I to have a severe reaction to the vaccine?

A: It's been reported that serious side effects from vaccines are extremely rare. For example, if 1 million doses of a vaccine are given, 1 to 2 people may have a severe allergic reaction Reactions to the vaccine are far less common and far less severe than are reactions to being infected with COVID.

Q: How long does immunity last with vaccination?

A: Immunity is still being studied, but COVID-19 vaccines provide immunity for at least six months and likely much longer.

Q: How soon before surgery should I get vaccinated?

A: You should wait until you receive full immunity after receiving your vaccine dosage before you have surgery. This timeline depends on your vaccine type. Let me go over the different types of vaccinations available at our medical center and draw you a timeline of when you should have the shot(s) and when we can schedule your operation. My office can also schedule vaccinations for you if you're interested.

Q: Am I likely to get COVID after I'm vaccinated? Does the Delta variant affect this?

A: No vaccine is 100% effective so this type of "breakthrough case" is possible, and a large proportion of the U.S. is still not vaccinated. Vaccines are effective against the Delta variant, but infections are still possible. There is good evidence that vaccines will dramatically lower chances of severe illness that leads to hospitalization and death should you get a breakthrough infection. It's recently been reported by the CDC that nearly all COVID deaths in the U.S. are now among unvaccinated persons. Some public officials have warned COVID is becoming a "pandemic of the unvaccinated."

2. Hospital policy questions

Q: Do I need a COVID test before an elective procedure?

Note: COVID testing requirements before an elective procedure can be different in each state or hospital. Check with your hospital administration or state department of public health for up-to-date guidance.

A: The policy about pre-surgery testing at our hospital is:

Note: Hospital guidelines are primary for this discussion and will likely draw from state guidelines. For an example of one state's guidance, visit the Illinois Department of Health website.

Q: Due to COVID restrictions, are family/friends allowed to accompany me to the hospital the day of surgery? And if I am admitted for an overnight stay, can they visit me in my hospital room?

A: Our hospital policy about family and friends being on-site to support you is as follows:

In general, these are things recommended by experts that you should also think about:

  • Visits should be scheduled to allow enough time for your visitors to be screened for the virus if required during the time they come here. They may also be asked to spend time being educated about COVID.
  • Your visitors should consider any risks to their own health if they come to the hospital. Visitors who are at high risk for severe illness from COVID, such as older adults and those with underlying medical conditions, should consider staying home. Ask them to call or video chat with you instead.

Q: Do I need a COVID test if I go to the emergency room?

A: Many hospitals are testing for COVID-19 upon patient arrival. Our hospital practice is:

conversation starter

Surgeon: Surgeons know how important it is to wear masks to stop the spread of infection. I wear one every time I'm in the operating room to protect myself and my patients.

3. About masks

Q: Because of the Delta variant, should vaccinated and unvaccinated people wear masks in public?

A: On July 27, CDC mask recommendations changed based on new evidence about the rise in cases due to the Delta variant. The CDC recommends "fully vaccinated people…wear a mask in public indoor settings in areas of substantial or high transmission." Also, "fully vaccinated people might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19, or if they have someone in their household who is immunocompromised, at increased risk of severe disease, or not fully vaccinated."

In other venues, masks are still encouraged, especially in areas with low vaccination rates. Local guidelines may vary; be sure to check guidelines for your city, county, or state.

Q: What's the best type of mask to use?

A:

  • Medical procedure masks (sometimes referred to as surgical masks or disposable face masks)
  • Masks that fit properly (snugly around the nose and chin with no large gaps around the sides of the face)
  • Masks made with breathable fabric (such as cotton)
  • Masks made with tightly woven fabric (i.e., fabrics that do not let light pass through when held up to a light source)
  • Masks with two or three layers
  • Masks with inner filter pockets

This document draws from data and reports available as of 8/23/21.