Thank you for your recent inquiry.
Of course, since the influenza vaccine is a killed virus, there is certainly no contraindication to administering it to a patient taking prednisone. I assume therefore you are concerned whether or not immunization with a standard dose will result in a protective response.
In this regard, prednisone at high doses over long periods of time can suppress antibody response to immunization. Whether or not it would do so in any individual case cannot be predetermined. Thus one cannot state specifically as to whether or not your patient might have a diminished response to the vaccine. However, I think that this is unlikely at a dose of 15 mg per day.
Nonetheless, if you were concerned about an antibody response, you could obtain pre- and post-immunization titers to assess the efficacy of a standard dose. Otherwise you could consider giving two doses or use the stronger vaccine suggested for individuals over 65 years of age. If you were still concerned, you could of course, once again, do pre- and post-immunization titers.
Thank you again for your inquiry and we hope this response is helpful to you.
Phil Lieberman, M.D.