From the Guidelines
It is generally safe to receive the Shingrix vaccine while taking budesonide, but consult with your healthcare provider first. Budesonide is a corticosteroid that can potentially weaken the immune system, especially at higher doses or with long-term use, which might reduce vaccine effectiveness. However, Shingrix is a non-live recombinant vaccine, making it safer for people on immunosuppressive medications compared to live vaccines, as noted in a study published in the Annals of the Rheumatic Diseases 1. The timing of vaccination might be optimized by your doctor based on your budesonide dosage, administration route (inhaled, oral, or topical), and treatment duration.
Common side effects of Shingrix include pain at the injection site, muscle aches, and fatigue, which are typically manageable. Remember that shingles can be more severe in immunocompromised individuals, so vaccination is particularly important for protection. The CDC recommends 2 doses of recombinant zoster vaccine (RZV, Shingrix) 2 to 6 months apart as the preferred vaccine over zoster vaccine live (ZVL, Zostavax), which is a live vaccine, as stated in the American Journal of Kidney Diseases 2. Your healthcare provider can evaluate your specific situation, considering your medical history and current health status, to determine the best approach for receiving the Shingrix vaccine while on budesonide.
Some key points to consider:
- Shingrix is recommended for adults 50 years and older, including immunosuppressed patients, as mentioned in the Annals of the Rheumatic Diseases 1.
- The vaccine is administered in two intramuscular doses provided 2 to 6 months apart.
- Shingrix has been shown to be safe and more efficacious compared with live-attenuated vaccine in elderly adults.
- The safety and efficacy of the subunit zoster vaccine have not yet been investigated in AIIRD patients, but it may replace the live-attenuated vaccine in patients with AIIRD, as noted in the Annals of the Rheumatic Diseases 1.
From the Research
Shingrix Vaccine While on Budesonide
- The Shingrix vaccine is a recombinant zoster vaccine that has been shown to be effective in preventing herpes zoster (shingles) in adults aged 50 years and older 3, 4, 5.
- The vaccine is administered in two doses, given 2-6 months apart, and has been shown to have an overall vaccine efficacy of 97.2% among participants 50 years of age or older 5.
- There is limited information on the use of the Shingrix vaccine in patients taking immunosuppressive medications such as budesonide.
- However, one study suggests that the zoster vaccine may be effective in preventing herpes zoster reactivation in patients with inflammatory bowel disease (IBD) who are taking immunosuppressive medications, including budesonide 6.
- Another study found that the Shingrix vaccine was effective among individuals with immunosuppressive conditions, including those taking medications such as budesonide 3.
- It is recommended that patients with IBD who are taking immunosuppressive medications, including budesonide, discuss the potential benefits and risks of the Shingrix vaccine with their healthcare provider 6.
Immunocompromised Individuals
- The Shingrix vaccine is nonreplicating and is thus safe in immunocompromised persons, including those taking immunosuppressive medications such as budesonide 4.
- The vaccine has been shown to be effective in preventing herpes zoster in immunocompromised individuals, including those with autoimmune conditions 3, 4.
Budesonide and Shingrix Vaccine
- There is limited information on the specific interaction between budesonide and the Shingrix vaccine.
- However, based on the available evidence, it appears that the Shingrix vaccine may be effective and safe in patients taking budesonide, including those with IBD or other immunosuppressive conditions 3, 6.