5+ Vaccines to Get While on Prednisone + 3 to Avoid

Amid a rising measles outbreak, understanding how vaccinations intersect with prednisone use is more important than ever. Individuals taking prednisone face heightened infection risks, making informed vaccination strategies a key part of their health management plan.

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Understanding Prednisone and Its Infection Risks

Prednisone, a glucocorticoid, is commonly prescribed for conditions like autoimmune diseases and organ transplants due to its powerful immunosuppressive effects. However, this suppression also increases vulnerability to infections.

Risk Statistics: Even low doses (under 5 mg daily) raise infection-related hospitalization risk by 34–35%. At 5–10 mg, the risk doubles, and at doses above 10 mg, it triples.
Influencing Factors: Age and dosage significantly impact these infection rates, which can range from 5.2% to 17.7%.

This data highlights why timely and appropriate vaccinations are vital for those on prednisone.

Vaccination Challenges and Best Practices

While vaccines are crucial, prednisone can dampen the body’s ability to respond effectively.

Efficacy Concerns: A study on lupus patients showed a 75% decrease in vaccine effectiveness among those taking prednisone.
Consultation is Key: Patients should work with their healthcare providers to develop a vaccination plan that considers their dosage, health status, and timing.

Top 5 Vaccines Recommended for Prednisone Users

Here are the most critical vaccines for individuals on prednisone therapy:

Flu Shot
Reduces doctor visits by 40%, ICU admissions by 26%, and mortality by 31%. Annual updates make it more effective against seasonal strains.
RSV Vaccine
Recommended for adults over 60 and pregnant women in their third trimester. Especially effective for prednisone users, reducing hospitalizations by up to 75%.
COVID-19 (SARS-CoV-2) Vaccine
Boosters are advised every six months for immunocompromised individuals to reduce hospitalization and death rates.
Shingrix (Shingles Vaccine)
90% effective in preventing shingles. Strongly recommended for adults over 50 and younger people with compromised immune systems.
PCV20 (Prevnar 20)
Protects against pneumococcal pneumonia, a serious threat to prednisone users and a leading cause of death in this population.

Vaccines to Avoid and Precautions to Take

Live vaccines pose a unique danger to those on prednisone:

Vaccines to Avoid: Zostavax (shingles) and MMR (measles, mumps, rubella) are typically not recommended.
Immunity Checks: Patients unsure of their measles immunity should verify their vaccination history or undergo blood testing.
Timing is Critical: If live vaccines are deemed necessary, they should only be administered at least one month after stopping prednisone or other immunosuppressants.

Beyond Vaccines: Additional Infection Prevention

Managing health while on prednisone goes beyond vaccinations:

Antiviral Measures: Discuss COVID-19 prophylactics and exposure-response strategies (e.g., for chickenpox or shingles) with a doctor.
PJP Pneumonia: While once considered a concern, new research suggests routine antibiotic prevention for Pneumocystis jirovecii pneumonia (PJP) may not be necessary unless other risk factors are present.

Managing Side Effects of Prednisone

Prednisone is a life-saving medication, but it demands careful management to counteract its side effects—especially the increased risk of infections. A proactive approach to vaccinations, preventive care, and side effect monitoring can empower patients to stay healthy and thrive.

Patients should actively manage these side effects with the help of healthcare providers. A free Prednisone Checklist is available for download, offering step-by-step guidance for protecting long-term health while on prednisone.