Administering Flu Shot with Steroids in Asthma Patients

Safety and Efficacy Considerations

• Influenza vaccination is specifically recommended for patients with asthma because they are at high risk for influenza-associated complications, according to the Mayo Clinic Proceedings 2

Corticosteroid Use and Vaccination Guidelines

• For patients with asthma taking the equivalent of prednisone ≥20 mg daily, administering influenza vaccination is conditionally recommended, as stated by the American College of Rheumatology 1, 3
• For patients taking lower doses of corticosteroids, there is no recommendation to delay influenza vaccination, as per the American College of Rheumatology 1

Type of Vaccine Considerations

• Inactivated influenza vaccine (flu shot) is appropriate for patients with asthma on corticosteroids, as recommended by the Centers for Disease Control and Prevention (CDC) 4, 5
• Live attenuated influenza vaccine (nasal spray) should NOT be used in patients with asthma or those receiving immunosuppressive therapies, according to the Advisory Committee on Immunization Practices (ACIP) 5, 6

Timing Considerations

• There is no need to time the influenza vaccination in relation to steroid administration for patients with asthma, as stated by the American College of Rheumatology 1
• Vaccination can be administered during routine visits beginning in September and throughout the influenza season, as recommended by the CDC 7
• The optimal time for organized vaccination campaigns is usually from October through mid-November, according to the CDC 8

Common Pitfalls to Avoid

• Do not administer live attenuated influenza vaccine (nasal spray) to patients with asthma - use only the inactivated influenza vaccine (injection), as recommended by the ACIP 5