Q:

11/21/2013
How significant is the effect of steroid premedication on the host immune response to the vaccines used for infectious diseases?

A:

Thank you for your inquiry.

There should be no effect of the administration of short-term, even short-term high dose, corticosteroids on the immune response to vaccines (see abstract copied below). It is conceivable that long-term (months) therapy might diminish a response, but I cannot give you a definitive answer because the effects would be highly dose-dependent.

Thank you again for your inquiry and we hope this response is helpful to you.

Corticosteroid effect on immunoglobulins.
Settipane GA, Pudupakkam RK, McGowan JH
J Allergy Clin Immunol. 1978;62(3):162.
The corticosteroid (prednisone) effect on serum immunoglobulins in 9 atopic asthmatic patients who required corticosteroids for the control of asthma was evaluated. Serum immunoglobulins were determined before corticosteroids were administered, an average of 15 days while on corticosteroids, and again an average of 22 days after corticosteroids were discontinued. While on corticosteroids (averaging 16.8 mg prednisone daily) for 15 days, mean serum IgG was significantly decreased (-22%, p less than or equal to 0.01), mean serum IgA tended to be decreased (-10%), and mean serum IgM was essentially unchanged. Serum IgE was initially significantly increased (p less than 0.01) when compared to levels of other serum immunoglobulins (IgG,A,M). An average of 22 days after corticosteroids were discontinued, mean serum IgG was still significantly decreased (p less than 0.05), and mean serum IgA again tended to be decreased. Serum IgM remained unchanged and mean serum IgE now was significantly decreased (p less than 0.01). Corticosteroids appear to have a significant effect on levels of some serum immunoglobulins.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology