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KMID : 0363120220350010014
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Korean Journal of Pain
2022 Volume.35 No. 1 p.14 ~ p.21
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Steroid injections in pain management: influence on coronavirus disease 2019 vaccines
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Hong Sung-Man
Park Yeon-Wook
Choi Eun-Joo
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Abstract
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The coronavirus disease 2019 (COVID-19) pandemic, which has been rampant since the end of 2019, has evidently affected pain management in clinical practice. Fortunately, a COVID-19 vaccination program is currently in progress worldwide. There is an ongoing discussion that pain management using steroid injections can decrease COVID-19 vaccine efficacy, although currently there is no direct evidence to support this statement. As such, the feeling of pain in patients is doubled in addition to the co-existing ill-effects of social isolation associated with the pandemic. Thus, in the COVID-19 era, it has become necessary that physicians be able to provide high quality pain management without negatively impacting COVID-19 vaccine efficacy. Steroids can alter the entire process involved in the generation of adaptive immunity after vaccination. The period of hypophysis-pituitary-adrenal axis suppression is known to be 1 to 4 weeks after steroid injection, and although the exact timing for peak efficacy of COVID-19 vaccines is slightly different for each vaccine, the average is approximately 2 weeks. It is suggested to avoid steroid injections for a total of 4 weeks (1 week before and after the two vaccine doses) for the doubleshot vaccines, and for 2 weeks in total (1 week before and after vaccination) for a single-shot vaccine. This review focuses on the basic concepts of the various COVID-19 vaccines, the effect of steroid injections on vaccine efficacy, and suggestions regarding an appropriate interval between the administration of steroid injections and the COVID-19 vaccine.
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KEYWORD
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Adaptive Immunity, Coronavirus, COVID-19, COVID-19 Vaccines, Immunization Programs, Immunosuppression, Injections, Nerve Block, Pain, Pain Management, Pandemics, Social Isolation, Steroids
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