Tuesday, March 21, 2023

Steroid Injection And Flu Vaccine

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What Can You Expect When You Get A Steroid Injection

ASPNs guidance for steroid therapies and COVID-19 Vaccine – Video abstract [ID 302115]

Before your injection, you may need to stop taking certain medications. Talk to your doctor about what medications you take. Dont make changes unless they tell you to.

Steroid injections must be done in a doctors office or hospital. Once you get to your appointment, your doctor will go over the procedure and have you sign a consent form. Then theyll have you lie in a way that allows them to access the injection site.

Your doctor may then use an ultrasound to figure out where exactly to give you the injection. Once they have the right place, theyll inject a mix of the steroid and a numbing medication. The shot may be uncomfortable, but the numbing medication will take effect quickly.

Injections can be given into:

  • joints
  • your spine
  • bursae, which are fluid-filled sacs between some tendons and joints

Youll need to keep the injection site clean and dry for the next 24 hours.

The site may be sore for a few days. You can use a cold pack on the injection site if you need to, for up to 10 minutes at a time. Wait at least 24 hours before using heat on the injection site.

Steroids can also be given through the veins . This method is usually used for autoimmune flares.

Immunization By Newly Developed Vaccines During The Covid

Adaptive immunity allows the body to remember pathogens that have previously invaded it and to develop a fast and strong subsequent immune response to that pathogen. This is the basic working principle behind the various vaccines in use today. Traditionally, inactivated and live attenuated vaccines have been used primarily, but recently, gene recombination techniques have been introduced in the development of vector vaccines or mRNA vaccines. These newly developed vaccines confer immunity via DNA or mRNA, which can express certain surface proteins of the target pathogen. These vaccines differ from traditional vaccines in the method of exposing antigens to the immune system, but the result is the same, that is, the formation of antibodies by the immune system. During the COVID-19 pandemic, numerous vaccines have been developed worldwide . Although these vaccines differ in their platform and immune acquisition process, the basic principle is the same in that they all promote the formation of antibodies against severe acute respiratory syndrome coronavirus 2 through an immune response.

1) Live attenuated vaccines

2) Inactivated vaccines

3) Vectored vaccines

4) Protein subunit vaccines

5) mRNA vaccines

6) DNA vaccines

Steroid Injections Into The Spine

A doctor may sometimes inject corticosteroids into the epidural area that surrounds the spine. The conditions that these injections treat include pain in the arms, legs, and lower back that results from inflamed spinal nerves.

Bony spurs, herniated disks, and other conditions can cause inflamed spinal nerves.

Read Also: Can You Carry The Flu Virus After Being Vaccinated

What Will Happen On The Day Of The Injection Procedure

Wear comfortable clothes and leave unnecessary valuables at home. Please complete all of your paperwork prior to arriving at the Anesthesiology/Pain Medicine Practice. The medical assistant will bring you back to an exam room, check your vital signs and verify your current medications.

Your physician will evaluate you and perform a physical exam. Your physician will discuss the steps involved in the procedure, the expected outcomes and potential risks and then answer any remaining questions you have. You will provide consent to permit your physician to do the procedure.

For most procedures, you will then be taken into the procedure room and positioned on a procedure table. For your safety, monitors will be placed to measure your blood pressure, heart rate and oxygen level.

We make every effort to make you comfortable during the entire process. After completion of the procedure, you will be monitored for any side effects. You will be given follow-up instructions during the discharge process.

How Can We Help

Cortisone Steroid injections and Covid Vaccination: Timing is Everything

Here at the My Knee Doc clinic we aim to put you front and centre of what we do. We have a great team who will listen to you, help you with your knee problem and guide you through your whole treatment journey. We aim to give you the best possible care from the first time we speak to you, perhaps on your free call, through your initial assessment in the clinic, to your treatment and your follow-up. We wont just discharge you once your treatment is complete. We have a complete aftercare package which means you always have access to our team of specialists.


  • Burns CM. The History of Cortisone Discovery and Development. Rheum Dis Clin North Am. 2016 Feb 42:1-14, vii. doi: 10.1016/j.rdc.2015.08.001. PMID: 26611547.
  • Sytsma TT, Greenlund LK, Greenlund LS. Joint corticosteroid injection associated with increased influenza risk. Mayo Clin Proc Innov Qual Outcomes 2018 2:194-198.
  • Abdul AJ, Ghai B, Bansal D, Sachdeva N, Bhansali A, Dhatt SS. Hypothalamic pituitary adrenocortical axis suppression following a single epidural injection of methylprednisolone acetate. Pain Physician 2017 20:E991-E1001.
  • Habib G, Jabbour A, Salman J, Hakim G, Haddad H. The effect of epidural methylprednisolone acetate injection on the hypothalamic-pituitary-adrenal axis. J Clin Anesth 2013 25:629-633.
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    Patients Should Be Careful When Considering Steroid Treatment

    With 10% of men and 13% of women older than 60 being diagnosed with osteoarthritis, the findings have implications for those with the most common joint disorder in the United States.

    An important takeaway, Guermazi said, is that doctors should inform patients of all the possible risks of steroid injections as they weigh treatment options together.

    Currently the American College of Rheumatology conditionally recommends steroid treatments and the Osteoarthritis Research Society International says they should be considered in patients with moderate to severe pain, the paper says.

    Guermazi wasnt ready to commit to how exactly the steroid treatments might actually cause osteoarthritis complications.

    But he said the studys observational evidence might be particularly relevant to younger patients mulling over steroid treatments, as it might lead to them needing joint replacements sooner.

    All in all, it still comes down to the patients choice.

    The researchers say patient preference should have a substantial influence on the type of treatment selected.

    How Can The Risk Of Infection Be Reduced If Im Taking Dmards

    Even if you do have vaccinations, if youre on treatment with DMARDs your blood count should be checked to make sure that your body is producing enough white blood cells. This is because a low white blood cell count will decrease your bodys ability to fight infection. If your white blood cells are low, this can normally be reversed by stopping the drug and in some cases taking other drugs to improve the production of white blood cells. Examples include folic acid if youre on methotrexate or use of a cholestyramine washout if youre on leflunomide. This will increase your bodys ability to fight infection.

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    Intranasal Steroids And The Flumist Vaccine

    Q: Can someone who is using an intranasal steroid such as fluticasone still receive the Flumist version of the flu vaccine?

    A: Great question! Flumist does not list any specifics but I spoke with Glaxo-Smith-Kline, the manufacturer of the intranasal steroid Flonase and they advised against using the nasal vaccine if you are currently using an intranasal steroid. The drug information insert that comes with fluticasone also recommends against using intranasal steroids if you have a viral infection present.

    Other common intranasal steroids include mometasone , triamcinolone , budesonide and beclamethasone . If you are using any of these medications, be sure to talk with your health care provider prior to receiving a nasal spray version of the flu vaccine.

    Roger Miller, MD

    Steroids Can Reduce The Body’s Response To Covid

    Get your flu shot today and help stop the spread of flu

    Steroids, also known as corticosteroids, are anti-inflammatory medicines used to treat a range of inflammatory conditions. These medications also reduce the activity of the immune system. Prednisone and dexamethasone are steroids that may be prescribed for conditions like arthritis, colitis, asthma, bronchitis, skin problems, allergies, and sinus infections.

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    What Should I Look Out For If I Have A Vaccination


    The flu vaccine should provide enough protection, but if you do develop flu-like symptoms, especially if you had the vaccine while on rituximab, please speak to your doctor about antiviral treatment, which should be started within the first 48 hours of symptoms.


    Pneumococcal vaccination will only provide protection against pneumococcal pneumonia. If you develop a high fever, breathlessness, and a cough with green spit, seek medical help immediately as its likely that youll need antibiotics to stop the infection developing.

    How Are Steroids Given

    Steroid drugs come in several forms that differ in how easily they dissolve or how long they stay in your body.

    Your doctor may give you steroids throughout your entire body or only in an affected area .

    You might get systemic steroids:

    • Through a vein
    • Into a muscle

    Local steroids can come as:

    • Eyedrops
    • Skin creams
    • Injections into joints, bursae , or around tendons and other soft tissue areas

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    How Do I Have Local Steroid Injections And How Long Do They Take To Work

    Steroid injections can be given by your doctor . Most injections are quick and easy to perform but the injection must be given in a very clean environment to prevent infection.

    You should rest the injected joint for 1-2 days after the injection and avoid strenuous activity for five days. The steroid injection can be repeated if the first injection is effective. However, you should not have more than four steroid injections into the same place in any 12-month period.

    Can Live Attenuated Influenza Vaccine Be Given At The Same Time As Other Vaccines

    Flu Vaccine Advice

    Live, attenuated influenza vaccine may be administered simultaneously with other live or inactivated vaccines. However, if two live, attenuated vaccines are not given during the same clinical visit, they should be separated by at least 4 weeks to minimize the potential risk for interference. For example, if live, attenuated influenza vaccine was given, at least 4 weeks should pass before MMR is administered.

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    Can Inactivated Influenza Vaccine Be Given At The Same Time As Other Vaccines Such As Pneumococcal Polysaccharide Or Zoster Vaccines

    Yes if other vaccines are indicated, they can be administered during the same clinical encounter as inactivated influenza vaccine. When giving several injections at a single visit, administer each vaccine at a separate injection site. The injection sites should be separated by 1 inch or more, if possible, so that any local reactions can be differentiated.

    Steroid Injections For Cancer

    A doctor may prescribe steroids, sometimes by injection, for people with cancer. In some cases, they might do this to treat the cancer itself. In others, they will use steroids to try to reduce:

    • sickness, hopefully increasing appetite as a result
    • allergic reactions to other drugs
    • inflammation
    • the immune response for example, after a bone marrow transplant

    Read Also: Flu Vaccine Different For Over 65

    What Role Do Steroid Injections Play In An Overall Treatment Plan

    Depending on your case, your doctor may give you steroid injections along with pain medications, anti-inflammatory drugs, physical therapy, occupational therapy, or devices such as canes and braces.

    For example, if you donât have any other health problems, a local steroid injection might be all you need for tendinitis. But if you have a condition like rheumatoid arthritis, injections will be only one part of your treatment plan.

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    The Impact Of Epidural Steroids And Immunocompetence

    Your Healthy Family: Flu shot misconceptions

    Epidural steroid injections represent an integral component of modern-day pain management for many patients. The theoretical risk of immunosuppression from neuraxial steroid administration and potentially deleterious effects on vaccine efficacy is of great interest to pain providers and patients.

    Glucocorticoid steroids have been considered immunosuppressive since the 1990s when it was discovered that they interfered with the signaling of inflammatory transcriptional regulators NF-kB and AP-1. Acutely, glucocorticoids inhibit the vasodilatory effects from inflammation, decrease vascular permeability caused by inflammatory insults, and decrease leukocyte emigration to the site of injury. Post-injury, glucocorticoid steroids affect the transcription of various genes in leukocytes resulting in immunosuppression and anti-inflammation. Recently, studies have suggested that glucocorticoids have a pro-inflammatory effect that can restore leukocyte function in preparation for further insult.

    While epidural steroids may be absorbed systemically, based on current dosing strategies and the pharmacodynamics of these injections, they are unlikely to demonstrate the immunosuppressive effects associated with chronic high-dose systemic steroid use.

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    Talk To Your Doctor Before Altering Your Treatment Plan

    All experts stress that before altering any treatment you’re receiving, steroid injections included, ahead of your COVID vaccine, you must speak to your doctor. “Talk to your provider about when it would be safe to get the COVID-19 vaccine because there are always exceptions to every rule,” Vyas says. “Cancer therapies, immune suppression or if you have a rheumatologic disease and you need certain shots or injections every month, don’t put those off.”ae0fcc31ae342fd3a1346ebb1f342fcb

    In addition, the Food and Drug Administration also advises that you should make your vaccine provider aware if you have any of the following conditions: allergies fever a bleeding disorder or you’re on blood thinners are immunocompromised are pregnant or planning to become pregnant are breastfeeding have received another COVID-19 vaccine. This will ensure that your vaccination goes according to plan.

    But in general, Vyas says, people with preexisting conditions shouldn’t worry. “If you have hypertension or another common medical condition, you can have a little more peace of mind knowing that they did studies and trials on the COVID-19 vaccines which included people with the same conditions. The good news is that they responded well to the vaccines. So, don’t change any of your regular medications,” she says. And for more on how long the vaccine keeps you safe, check out Dr. Fauci Says Your COVID Vaccine Protects You For This Long.

    I Am Late Or Cannot Get To My Appointment Today What Are My Options

    We want to treat all our patients with compassion and respect. Part of being respectful is punctuality. We know people have busy schedules and we want to get patients seen in a timely manner. This can be difficult if patients show up late. We ask that patients arrive 10 to 15 minutes before their scheduled appointment with all of their paperwork already completed.

    There is very little wait time once you arrive at the Anesthesiology/Pain Medicine Practice. Late patients, regardless of the reason, may have their appointment rescheduled.

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    Steroid Injections May Lead To More Long

    Doctors and patients should beware if theyre hoping to use steroid injections to relieve the pain associated with osteoarthritis.

    The shots may be doing more harm than good.

    In a new study published in the journal Radiology, researchers looked at 459 patients in a US hospital who had received one to three corticosteroid injections into a knee or hip.

    Of those patients, 36 of them, or 8%, experienced adverse events in their joints, as shown on medical imaging tests.

    Researchers saw acceleration of the patients osteoarthritis progression, as well as other negative effects including subchondral insufficiency fracture, osteonecrosis and rapid joint destruction with bone loss.

    Ali Guermazi, a radiology professor at Boston University and a co-author of the study, told CNN the paper built on another 2019 study that showed similar results.

    The evidence is stacking up, and the negative effects might have actually extended higher than the 8% of patients with complications seen in the study so far, he said.

    He cautioned, however, that it was just an observational study, and scientists would still need to do a double-blind study to back up these findings.

    The results offer food for thought as patients are reckoning with ailing joints.

    Cortisone Steroid Injections And Covid Vaccination

    Boston Sports

    Cortisone or steroid injections are commonly used by Orthopaedic Surgeons, Rheumatologists, GPs and Pain Specialists to help people manage inflammation and pain due to knee osteoarthritis.

    I regularly use this effective treatment in my specialist knee clinic because it really does help people get control of their symptoms and can really be a life changing treatment.

    We do know however that Cortisone, a form of steroid, can have effects on your immune system.Covid-19 vaccinations are taking place around the world. Millions of vaccinations have already been administered in the UK alone.

    I know how important it is to give you the right information and tools so you can make the right decision about your healthcare. Ill make sure I give you the best advice even if its just reassurance

    Some patients have asked the question Is it safe to have a cortisone injection after my vaccine? Ive looked into the current advice and research and hopefully Ill be able to answer that question and reassure people in this article.

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    How Long Do They Last

    Steroid shots usually last up to one or two months. However, they can last longer, especially when used with other treatments such as physical therapy. Injections for certain conditions, such as acute joint pain, may also last longer.

    Its best to limit steroid injections to three or four times a year. More frequent injections can cause the skin and bone around the injection site to weaken.

    How Often Can A Person Receive Them

    A person can receive hydrocortisone injections into the same joint up to four times a year. A higher frequency of injections can cause damage to the joint.

    Doctors often prescribe one or two short courses of intravenous steroids before switching to treatment with oral steroids. There are limits to their use to reduce the risk of side effects.

    For example, the United Kingdoms National Health Service advise that people with MS do not take steroids more than three times a year.

    The possible side effects of steroid injections vary depending on their use.

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