Recommendations and Guidance for Steroid Injection Therapy and COVID-19 Vaccine Administration from the American Society of Pain and Neuroscience (ASPN)

Krishnan Chakravarthy; Natalie Strand; Anne Frosch; Dawood Sayed; Lakshmi Rekha Narra; Rahul Chaturvedi; Prabhdeep K Grewal; Jason Pope; Michael E Schatman; Timothy Deer

doi:10.2147/JPR.S302115

Recommendations and Guidance for Steroid Injection Therapy and COVID-19 Vaccine Administration from the American Society of Pain and Neuroscience (ASPN)

J Pain Res. 2021 Mar 5:14:623-629. doi: 10.2147/JPR.S302115. eCollection 2021.

Authors

Krishnan Chakravarthy^{1

2}, Natalie Strand³, Anne Frosch^{4

5}, Dawood Sayed⁶, Lakshmi Rekha Narra¹, Rahul Chaturvedi¹, Prabhdeep K Grewal⁷, Jason Pope⁸, Michael E Schatman^{9

10}, Timothy Deer¹¹

Affiliations

¹ Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, San Diego, CA, USA.
² VA San Diego Healthcare System, San Diego, CA, USA.
³ Department of Anesthesiology and Pain Medicine, Mayo Clinic, Phoenix, AZ, USA.
⁴ Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
⁵ Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
⁶ Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
⁷ Pain Medicine, TSAOG Orthopaedics, San Antonio, TX, USA.
⁸ Evolve Restorative Center, Santa Rosa, CA, USA.
⁹ Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA.
¹⁰ Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
¹¹ Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA.

Abstract

To date, COVID-19 has spread to more than 108 million people globally, with a death toll surpassing 2 1/2 million. With the United States Food and Drug Administration (FDA) approval of two highly effective COVID-19 vaccines from Pfizer-BioNtech and Moderna, we now have a novel approach to contain COVID-19 related morbidity and mortality. Chronic pain care has faced unprecedented challenges for patients and providers in this ever-changing climate. With the approval of COVID-19 vaccines, we now face questions relating to the potential effects of pain treatments utilizing steroids on vaccine efficacy. In this analysis, we address these issues and provide guidance for steroid therapies based on available data and expert recommendations.

Keywords: COVID-19; chronic pain; epidural steroid injections; interventional pain therapy; vaccines.

Grants and funding

K08 AI141761/AI/NIAID NIH HHS/United States