COVID Booster Jab and Oral Corticosteroids...

[Epona]

OH is due for his booster tomorrow which was booked a while ago, however due to a bad asthma attack and hospitalisation on Monday he is currently on a high-dose short course of oral prednisolone to get his asthma under control.

I think that the steroid treatment means he won't have a normal immune response to the booster rendering it less effective, and he should delay the jab for something like 10 days (5 day course of steroids plus time to get back to normal once the course is finished - also no question that he is going to have it, just a matter of timing it properly with regard to other treatment he is currently undergoing).

Any thoughts?

 

[LDC]

OH is due for his booster tomorrow which was booked a while ago, however due to a bad asthma attack and hospitalisation on Monday he is currently on a high-dose short course of oral prednisolone to get his asthma under control.

I think that the steroid treatment means he won't have a normal immune response to the booster rendering it less effective, and he should delay the jab for something like 10 days (5 day course of steroids plus time to get back to normal once the course is finished - also no question that he is going to have it, just a matter of timing it properly with regard to other treatment he is currently undergoing).

Any thoughts?

Why do you think that, have you read something, or seen related guidance? IIRC there's something about no live vaccines while on them, but in this case I've no idea tbh, too specialist for me. Ask at the vaccination centre, or phone his GP/specialist/asthma nurse maybe?

 

[iona]

OH is due for his booster tomorrow which was booked a while ago, however due to a bad asthma attack and hospitalisation on Monday he is currently on a high-dose short course of oral prednisolone to get his asthma under control.

I think that the steroid treatment means he won't have a normal immune response to the booster rendering it less effective, and he should delay the jab for something like 10 days (5 day course of steroids plus time to get back to normal once the course is finished - also no question that he is going to have it, just a matter of timing it properly with regard to other treatment he is currently undergoing).

Any thoughts?

Specialist Pharmacy Sevice says this (from here)

Patients being treated with corticosteroids (oral, intra-articular, intra-muscular or intravenous)​

The British Society of Rheumatology endorse this advice from Arthritis and Musculoskeletal Alliance (ARMA)

There are some general principles but in each case the benefits and risks should be discussed with the patient to arrive at a shared decision:

• It is safe to have the COVID-19 vaccine alongside steroid exposure, but the patient may not mount such a good immune response.
• Do not delay vaccination for someone who is taking, has received or is soon to receive steroids in any form.
• If additional steroids are required to control inflammatory disease, that may take priority, as a flare can also worsen the risk from COVID-19
• It may be appropriate to delay a non-essential steroid injection, as part of a shared decision, so that the response to the vaccine is more effective. For a patient who is on an elective waiting list for a steroid injection of up to 80mg methylprednisolone or 80mg triamcinolone, the administration of the COVID-19 vaccine is the priority if the vaccine has been offered to the patient and the prevalence of COVID-19 is high. In this scenario, the steroid injection should be deferred by 2 weeks after the vaccine, to enable the patient to mount the best response to the COVID-19 vaccine.

The Green Book suggests giving vaccinations slightly early where vaccinating on schedule would coincide with planned immunosuppressive treatment but doesn't say anything about delaying vaccination after a course of corticosteroids.

(IANAD etc)

 

[farmerbarleymow]

This looks like an interesting study on vaccine effectiveness and immune-suppressing drugs. The study is on methotrexate rather than prednisolone, and will take a couple of years to complete.

Covid: Medication holiday may boost vaccine protection

A trial will look at how to protect patients against Covid who also need immunosuppressant drugs.

www.bbc.co.uk

 

[Epona]

My concern was NOT about whether the vaccine would do anything horrible to him, but whether his body would be able to mount a full immune response to the vaccine and have it be a fully effective booster while he was on a heavy temporary steroid dose (or whether he should delay the booster for 7-10 days until he was off the steroids).

He asked the pharmacist when he went in for the booster and they weren't concerned so he had the pfizer booster.

He was OK immediately afterwards but over the next couple of days had some fairly weird mild symptoms that were probably more to do with the steroids but he is on oral steroids frequently and never had anything like that before, but there was nothing that is known side effects of the vaccine either, he is also on a number of other medications and it was probably just a combination of meds and tiredness - and it wasn't serious and cleared up quickly.

 

[MrCurry]

My doc said that while I was taking the prednisone, I would have less benefit from the covid vaccine than normal, but to go ahead and get the jab anyway. It’s hard to quantify this to know how much less protection I got from it, so I’ll choose to believe it’s a mild effect rather than a severe reduction.

Also, is the reduction in immune response immediately from when you begin the corto some pills, or does that only show up after a while? I don’t know, but if it’s the former and your husband is on a short course, maybe it’s ok?