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Joint Corticosteroid Injection Associated With Increased Influenza Risk
Terin T Sytsma1, Lindsey K Greenlund2, Laura S Greenlund1
1Department of Medicine, Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN.
Corticosteroid injections into joints may reduce influenza vaccine effectiveness. Vaccinated individuals receiving these injections showed a higher risk of developing influenza, particularly women under 65.
Area of Science:
- Immunology
- Vaccinology
- Rheumatology
Background:
- Influenza vaccine effectiveness can be diminished by aging and immunosuppression.
- High-dose influenza vaccines are used in older adults to enhance immune response.
- Systemic corticosteroid use may reduce vaccine effectiveness, but local joint injection data is lacking.
Purpose of the Study:
- To investigate the association between major joint corticosteroid injections and influenza vaccine effectiveness.
Main Methods:
- Retrospective study analyzing data from 5 influenza seasons (2012-2017) in Olmsted County, Minnesota.
- Included 15,068 major joint corticosteroid injections administered.
- Compared influenza risk in vaccinated patients who received joint injections versus vaccinated controls.
Main Results:
- Vaccinated patients receiving major joint corticosteroid injections had a 1.52 times increased risk of influenza.
- The increased risk was most pronounced in women younger than 65 years.
- Confidence interval (CI) was 1.20-1.93.
Conclusions:
- Major joint corticosteroid injections may be associated with reduced influenza vaccine effectiveness.
- Consideration of high-dose influenza vaccines may be warranted for women under 65 receiving joint injections.
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