Department of Orthopedic Surgery, University of California, San Diego, San Diego, California, USA.
University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA.
Pain Med. 2021 Jun 4;22(6):1441-1464. doi: 10.1093/pm/pnab130.
Corticosteroid injection for the treatment of pain is known to decrease the efficacy of the adenovirus vector-based vaccines for COVID-19.
There is currently no direct evidence to suggest that a corticosteroid injection before or after the administration of an adenovirus vector-based COVID-19 vaccine decreases the efficacy of the vaccine. However, based on the known timeline of hypothalamic-pituitary-adrenal axis suppression following epidural and intraarticular corticosteroid injections, and the timeline of the reported peak efficacy of the Janssen and AstraZeneca vaccines, physicians should consider timing an elective corticosteroid injection such that it is administered no less than 2 weeks prior to and no less than 2 weeks following a COVID-19 adenovirus vector-based vaccine dose, whenever possible. We emphasize the importance of risk/benefit analysis and shared decision making in determining the timing of corticosteroid injections for pain indications in relation to receipt of a COVID-19 vaccine given that patient-specific factors will vary.
用于治疗疼痛的皮质类固醇注射已知会降低 COVID-19 腺病毒载体疫苗的功效。
目前没有直接证据表明，在接种腺病毒载体 COVID-19 疫苗之前或之后进行皮质类固醇注射会降低疫苗的功效。然而，根据已知的硬膜外和关节内皮质类固醇注射后下丘脑-垂体-肾上腺轴抑制的时间以及 Janssen 和 AstraZeneca 疫苗报告的峰值功效时间，医生应考虑选择皮质类固醇注射的时间，以便在 COVID-19 腺病毒载体疫苗剂量之前至少 2 周和之后至少 2 周进行注射，只要有可能。我们强调在确定皮质类固醇注射治疗疼痛的时间与接种 COVID-19 疫苗之间的关系时，进行风险/收益分析和共同决策的重要性，因为患者的具体情况会有所不同。
