When taking prednisone, a commonly prescribed steroid, it’s important to be cautious about which shots to avoid and receive. We will also explore other vaccines to avoid and debunk common myths surrounding vaccines and prednisone use. By being informed and working with your healthcare provider, you can make the best decisions for your health and well-being while on prednisone.

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1. Live Attenuated Influenza Vaccine (LAIV)

The LAIV, also known as the nasal spray flu vaccine, contains live, weakened viruses. While this vaccine is effective in preventing influenza, it is not recommended for individuals on prednisone or other immunosuppressive medications. The live viruses in the vaccine can pose a risk to those with compromised immune systems, such as individuals taking prednisone. It is important to opt for the injectable flu vaccine instead of the nasal spray while on prednisone to avoid any potential complications.

Find out other questions about prednisone and the influenza vaccine “Prednisone: Flu shot not“. Read this article and watch this video below.

2. Measles, mumps, rubella (MMR) combined vaccine

The MMR vaccine is a live vaccine that protects against measles, mumps, and rubella. Like the LAIV, the MMR vaccine contains live attenuated viruses and should be avoided by individuals on prednisone. The live viruses in the vaccine can potentially cause infections in individuals with weakened immune systems, such as those taking prednisone. It is important to consult with your healthcare provider about alternative vaccine options if you are on prednisone and require protection against measles, mumps, and rubella.

3. Chickenpox/Shingles Vaccine (Varicella)

Most people who are currently taking prednisone got chickenpox as a child. Children nowadays get chickenpox shots so they never have to go through what older had to go through getting terrible chickenpox scars.

If you have had chickenpox as a child, then later on you are at a greater risk for what’s called shingles. This is a reactivation of the same virus that causes chickenpox because it never actually goes away and hides in your nerve cells. When you are immunosuppressed, it can reactivate and cause painful rashes usually on your torso.

You have to get a vaccine to prevent the reactivation of that. And there are two options for this. The first one is a live vaccine and it is called Zostavax.

The Zostavax vaccine, which is used to prevent shingles, contains live viruses and should be avoided while on prednisone.

However, the Shingrix vaccine is a safe alternative for individuals on prednisone as it is a recombinant vaccine that does not contain live viruses.

Shingrix is highly effective in preventing shingles and is recommended for individuals over the age of 50, including those on immunosuppressive medications like prednisone.

Be sure to discuss your vaccination options with your healthcare provider to determine the best course of action for protecting yourself against shingles while on prednisone.

Other Shots to Avoid While on Prednisone

(Not applicable to most people on prednisone)

Rotavirus Vaccine

The rotavirus vaccine should be avoided by individuals taking prednisone. It is a live vaccine that may pose a risk to those with weakened immune systems. This is normally given to infants and most people on prednisone are not newborns.

Yellow Fever Vaccine

Individuals on prednisone should avoid the yellow fever vaccine. It contains live attenuated viruses that can potentially cause complications in those with compromised immune systems.

This is only necessary if you are traveling to a place where there is a yellow fever. Most people on prednisone are not traveling to a yellow fever zone.

Smallpox Vaccine

The smallpox vaccine is another live vaccine and should be one of the shots to be avoided by individuals on prednisone. Similar to yellow fever, most people taking prednisone are not traveling to a place where there is smallpox.

According to CDC:

Substantially immunosuppressive steroid dose is considered to be ≥2 weeks of daily receipt of 20 mg or 2 mg/kg body weight of prednisone or equivalent.

Here is another vaccine that the CDC says to avoid if you are immunosuppressed:

• Dengue

Myths about Prednisone and Vaccines

1. (HPV) Human Papillomavirus Vaccine

This shot is given to people 11-26 years old (and up to age 45) to prevent cancer from HPV, a sexually transmitted disease.

Contrary to popular belief, individuals on prednisone can safely receive the HPV vaccine. The HPV vaccine is not a live vaccine and does not pose a risk to individuals with weakened immune systems. It is important to follow the recommendations of your healthcare provider and get vaccinated against HPV to protect yourself from certain types of cancer.

2. (Tdap) Tetanus, diphtheria, and acellular pertussis Vaccine

The TDAP vaccine, which protects against tetanus, diphtheria, and pertussis, is safe for individuals on prednisone. The vaccine does not contain live viruses and is recommended for individuals of all ages, including those with compromised immune systems.

It is important to stay up to date on your TDAP vaccination to protect yourself and others from these preventable diseases. People thought you couldn’t get it if you were immunosuppressed, but it is okay to get it.

3. Rotavirus Vaccine

They used to think that they couldn’t give it to the infant if there was someone else in the house who was immunosuppressed. That is not true. It’s fine even if a family member is immunosuppressed for the child to get a rotavirus vaccine.

Most Important Myth: You can’t get any vaccines while on prednisone

This myth is not accurate, as many shots are safe for individuals on prednisone. Most shots are fine.

However, you may not have as robust or as good of an immune response as you would otherwise get if you weren’t on prednisone.

Whether it’s the COVID-19 vaccine, flu vaccine, or any other vaccine, if you’re taking high doses of prednisone, you may just not be able to mount as good of a response and get the same effect that someone else would have if they have a normal immune system. After you stop taking prednisone, there’s a chance you may need to be revaccinated.

Check out this article and video for my answer on how long to wait to restart prednisone after a flu shot.

It is important to work with your healthcare provider to develop a vaccination plan that meets your specific needs to ensure your immune system remains strong while on prednisone. By being informed and proactive about your vaccination status, you can protect yourself from preventable diseases and stay healthy while undergoing treatment with prednisone.

Now you know which vaccines to avoid (and which are okay), but do you know all of the other things you need to avoid while on prednisone?

If not, you need to download my brand new list: