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  • Glenn MacNichol, MD

COVID 19 Vaccine and Steroids

If you have recently gotten, or are planning to receive a COVID-19 vaccine soon, remember to tell your provider if you are offered a steroid injection.

Many painful conditions of the spine, joints, or connective tissue will improve quickly after a dose of corticosteroid, or ‘steroid’ as commonly known, either injection or oral forms. At CRO, we often identify such problems and offer you an injection of steroids or a course of steroid pills for a week.

While the steroid medication is very effective at reducing the pain associated with the inflammation, it also has a temporary effect on your body’s general immune response. In general, a single dose of injected steroid or a single course of oral steroid has no adverse impact on the body as a whole. Still, if it is given just before or soon after a vaccine, the steroid can reduce your body’s immune response to the vaccine. The effect then is to make the immunity from the vaccine less effective than it would otherwise be.

The CDC makes no specific recommendations on the timing of vaccination relative to steroid injection. However, an early investigation into the link between steroid injections and vaccine efficacy showed no impact on vaccine efficacy.

Through indirect evidence, and for maximum caution, we follow the Spine Intervention Society guidelines that recommend that after the COVID vaccine, elective steroid injection or pills should be avoided for 14 days after the second or the third (booster) vaccine to assure maximum response to the vaccine. After that time, the immune response will have been developed, and steroids will not affect it. Therefore, if you are in the middle of your two-dose primary series of vaccines, it is best to complete your second dose before getting a steroid injection.

Similar caution also recommends that, if you have recently had a steroid injection anywhere in your body or a brief course of steroid pills, that you postpone a planned COVID vaccine for at least 14 days to maximize the effectiveness of the vaccine.

These recommendations apply only to a single dose or short course of steroid treatment. If you are on chronic steroid treatment for a medical condition, DO NOT STOP YOUR TREATMENT WITHOUT CONSULTING WITH YOUR PHYSICIAN FIRST!

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