Triamcinolone Acetonide Scalp Steroid Injections for Hair Loss and Influenza Vaccines

Influenza and COVID Vaccines and Steroid Injections

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts related to the administration of the influenza vaccine in patients receiving scalp steroid injections.

Question

My treatment for scarring alopecia includes monthly injections of triamcinolone. Now that the fall covid and flu vaccines are available, do you have a recommendation on the timing of the injections with the timing of the vaccines so I get maximum benefit from the vaccines?

Answer

For patients receiving steroid injections into the scalp, there is not sufficient immunosuppression in the body caused by the steroid injections to alter the intramuscular flu or COVID vaccination recommendations. One should check with his or her doctor about whether these vaccines are important to have. If so, the use of scalp steroid injections does not alter the decision about having the vaccine.

Generally speaking, evidence showed that even with doses of prednisone up to 20 mg/day, patients can safety receive flu vaccines and COVID vaccines because the response to inactivated intramuscular vaccines is not suppressed.

REFERENCE

Rubin LG, Levin MJ, Ljungman P, et al. IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2013; 58(3): e44–e100.