Vaccines and steroids: what you need to know
If you’re taking steroids, especially at moderate or high doses, you might be wondering how that affects your ability to get vaccinated. It’s a really important question, and understanding the relationship between steroids and vaccines can help you stay protected without taking unnecessary risks.
Let’s start with the basics.
Why vaccines matter if you're on steroids
Steroids like prednisone and prednisolone work by dampening your immune system, which is often exactly what your body needs, especially when you’re dealing with autoimmune conditions or severe inflammation. However, this immune suppression can also make it harder for your body to respond effectively to vaccines and increase your risk of contracting infections.
That’s why vaccination remains an essential part of your care plan. But the type of vaccine and the timing matter.
Live vs. non-live vaccines
Live vaccines such as the MMR (measles/mumps/rubella) and yellow fever are not suitable for patients taking steroids. That’s because live vaccines contain weakened versions of the virus, and your immune system might not be strong enough to handle them safely while you’re on steroids.
On the other hand, non-live (or inactivated) vaccines such as the seasonal flu shot, the COVID-19 vaccines, and Shingrix (a newer vaccine for shingles) are usually considered safe, even if you’re on steroids. However, your immune response may be dulled. So, while the vaccine will still offer protection, it may not be quite as robust as it would be if you were not on steroids. Nevertheless, the use of these vaccines still offers at least some protection and is better than remaining unvaccinated.
Timing your vaccines
If you know you’ll be starting steroids soon and the start of treatment can be delayed until after vaccination, it’s a good idea to have any necessary vaccines before beginning treatment. It is ideal to wait at least two weeks after vaccination before beginning steroid treatment, as this gives your immune system the best chance to mount a full response. Often, however, the need to begin treatment immediately must take precedence over delaying treatment to permit vaccines to take hold.
If you’re already on steroids, especially a high dose or over a long period, talk with your healthcare provider. They may recommend delaying some vaccines until your steroid dose can be safely reduced. In some cases, they may decide it’s still better to go ahead with the vaccine, especially if the risk of being completely unvaccinated is high.
What else can you do?
Here are a few more tips to help support your immune system and make the most of your vaccines:
Keep an eye out for any unusual symptoms after vaccination, such as fever, fatigue, or rash, and report them to your healthcare provider.
Try to maintain a healthy lifestyle. Good sleep, balanced nutrition, and managing stress can all help your immune system work better, even if steroids are suppressing it.
Always work with your doctor to make the best decisions for your circumstances. Your steroid dose, how long you’ve been on it, and your overall medical condition all play a role in what’s safest and most effective for you.
Remember, vaccines are one of our most powerful tools to prevent serious infections. Even on steroids, staying up to date with your vaccinations can offer valuable protection and peace of mind.
Learn more about how steroids impact your risk of infection.