{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:21:25Z","timestamp":1772205685985,"version":"3.50.1"},"reference-count":83,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,2,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Corticosteroid injections (CSIs) are widely employed for chronic pain. These injections include peripheral nerve blocks and trigger point injections, injections of large appendicular joints, the axial facet and sacroiliac joints, and the epidural space. These injections may be performed in patients who have been recently vaccinated or plan to be vaccinated. This multisociety multispecialty position statement aims to develop evidence-based statements and recommendations (SRs) on the safe interval between CSIs and COVID-19 and influenza vaccine administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Development of the position statement was approved by the American Society of Regional Anesthesia and Pain Medicine Board of Directors and several other societies that agreed to participate. The scope of the SRs was agreed on to include the efficacy of COVID-19 and influenza vaccines, adverse events related to the CSIs, specifically the effect of CSIs on the hypothalamic\u2013pituitary axis, incidence of COVID-19 in patients who had CSIs during the pandemic, incidence of influenza in patients who had CSIs during the influenza season, and recommend a reasonable interval between CSIs and COVID-19 and influenza vaccination 20\u2009mg\/day of prednisone s. Experts were assigned topics to perform a comprehensive literature review and draft SRs, which were refined and voted for consensus (\u226575% agreement) using a modified Delphi process. A modified version of the US Preventive Services Task Force grading of evidence and strength of recommendation was followed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All SRs were approved by all participants after four rounds of discussion. The Practice Guidelines Committees and Boards of Directors of the participating societies also approved all SRs. If a vaccine has been recently administered or planned, then for non-urgent indications, the CSI should be offered at least 1\u2009week before or after vaccine administration. For healthy patient(s), CSI, or vaccine administration may be performed without a 7-day interval after informed discussion with the patient and consent regarding the risk of blunted vaccine efficacy. For non-healthy patients, shared decision-making should include discussion of diminished vaccine effectiveness and the possibility of influenza or COVID-19 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this position statement, we provide recommendations on the optimal timing between CSIs and COVID-19 or influenza vaccine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2025-107556","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:50:15Z","timestamp":1772203815000},"page":"rapm-2025-107556","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multisociety multispecialty position statement on corticosteroid injections and influenza and COVID-19 vaccine administration"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1376-8003","authenticated-orcid":false,"given":"Honorio T","family":"Benzon","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"FitzGerald","sequence":"additional","affiliation":[{"name":"Medicine (Rheumatology), UCLA, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P","family":"Flaherty","sequence":"additional","affiliation":[{"name":"Medicine (Infectious Diseases), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5928-2127","authenticated-orcid":false,"given":"Steven Paul","family":"Cohen","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology, Physical Medicine and Rehabilitation, Neurology, Psychiatry, and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5011-3298","authenticated-orcid":false,"given":"Tina L","family":"Doshi","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA"},{"name":"Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maged","family":"Mina","sequence":"additional","affiliation":[{"name":"Anesthesiology, The University of Texas Health Science Center, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salahadin","family":"Abdi","sequence":"additional","affiliation":[{"name":"Pain Medicine, MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Abd-Elsayed","sequence":"additional","affiliation":[{"name":"University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0570-9997","authenticated-orcid":false,"given":"Andrea","family":"Chadwick","sequence":"additional","affiliation":[{"name":"Anesthesiology, The University of Kansas School of Medicine, Kansas City, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxim S","family":"Eckmann","sequence":"additional","affiliation":[{"name":"Anesthesiology, The University of Texas Health Science Center, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalia","family":"Elmofty","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, University of Chicago Medical Center, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua Adam","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanh","family":"Hoang","sequence":"additional","affiliation":[{"name":"Endocrinology, Walter Reed Army Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0507-7889","authenticated-orcid":false,"given":"Christine","family":"Hunt","sequence":"additional","affiliation":[{"name":"Anesthesiology - Pain Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laxmaiah","family":"Manchikanti","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Louisville Health Sciences Center, Louisville, Kentucky, USA"},{"name":"Anesthesiology, LSU Health Sciences Center, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5642-3465","authenticated-orcid":false,"given":"Ameet","family":"Nagpal","sequence":"additional","affiliation":[{"name":"PM&R, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1575-1635","authenticated-orcid":false,"given":"Ariana M","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Irvine, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-8403","authenticated-orcid":false,"given":"Carlos","family":"Pino","sequence":"additional","affiliation":[{"name":"Anesthesiology, Naval Medical Center San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2147-3523","authenticated-orcid":false,"given":"David Anthony","family":"Provenzano","sequence":"additional","affiliation":[{"name":"Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maunak","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, University of Chicago Medical Center, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Rivera","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, LSUHSC, New Orleans, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalini","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Irvine, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1567-3887","authenticated-orcid":false,"given":"Hariharan","family":"Shankar","sequence":"additional","affiliation":[{"name":"Anesthesiology, Clement Zablocki VA Medical Center\/Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsha","family":"Shanthanna","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byron","family":"Schneider","sequence":"additional","affiliation":[{"name":"PM&R, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitri","family":"Souza","sequence":"additional","affiliation":[{"name":"Pain Medicine, Summa Western Reserve Hospital, Cuyahoga Falls, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Stout","sequence":"additional","affiliation":[{"name":"PM&R, Cleveland Clinic Neurological Institute, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-6077","authenticated-orcid":false,"given":"Ajay D","family":"Wasan","sequence":"additional","affiliation":[{"name":"Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1849-1402","authenticated-orcid":false,"given":"Samer","family":"Narouze","sequence":"additional","affiliation":[{"name":"University Hospitals of Cleveland, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Maus","sequence":"additional","affiliation":[{"name":"Radiology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022706501256000_rapm-2025-107556v1.1","doi-asserted-by":"crossref","unstructured":"Benzon HT , Elmofty D , Shankar H , et al . Use of corticosteroids for adult chronic pain interventions: sympathetic and peripheral nerve blocks, trigger point injections - guidelines from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, the American Society of Interventional Pain Physicians, and the International Pain and Spine Intervention Society. Reg Anesth Pain Med 2024. doi:10.1136\/rapm-2024-105593","DOI":"10.1136\/rapm-2024-105593"},{"key":"2026022706501256000_rapm-2025-107556v1.2","doi-asserted-by":"crossref","unstructured":"Benzon HT , Provenzano DA , Nagpal A , et al . Use and safety of corticosteroid injections in joints and musculoskeletal soft tissue: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, the American Society of Interventional Pain Physicians, and the International Pain and Spine Intervention Society. Reg Anesth Pain Med 2025. doi:10.1136\/rapm-2024-105656","DOI":"10.1136\/rapm-2025-106815"},{"key":"2026022706501256000_rapm-2025-107556v1.3","doi-asserted-by":"crossref","unstructured":"Benzon HT , Doshi T , Maus T , et al . Multi-society multi-specialty consensus recommendations on corticosteroid injections for facet joint and sacroiliac joint pain. Reg Anesth Pain Med 2026.","DOI":"10.1136\/rapm-2025-107347"},{"key":"2026022706501256000_rapm-2025-107556v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(01)00261-6"},{"key":"2026022706501256000_rapm-2025-107556v1.5","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1093\/pm\/pnab063","article-title":"Do Corticosteroid Injections for the Treatment of Pain Influence the Efficacy of mRNA COVID-19 Vaccines?","volume":"22","author":"Lee","year":"2021","journal-title":"Pain Med"},{"key":"2026022706501256000_rapm-2025-107556v1.6","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1093\/pm\/pnab130","article-title":"Do Corticosteroid Injections for the Treatment of Pain Influence the Efficacy of Adenovirus Vector-Based COVID-19 Vaccines?","volume":"22","author":"Lee","year":"2021","journal-title":"Pain Med"},{"key":"2026022706501256000_rapm-2025-107556v1.7","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7406a1"},{"key":"2026022706501256000_rapm-2025-107556v1.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMOA2510226"},{"key":"2026022706501256000_rapm-2025-107556v1.9","doi-asserted-by":"crossref","unstructured":"Chatzilena A , Hyams C , Challen R , et al . Relative vaccine effectiveness of mRNA COVID-19 boosters in people aged at least 75 years during the spring-summer (monovalent vaccine) and autumn-winter (bivalent vaccine) booster campaigns: a prospective test negative case\u2013control study, United Kingdom, 2022. Euro Surveill 2023;28. doi:10.2807\/1560-7917.ES.2023.28.48.2300173","DOI":"10.2807\/1560-7917.ES.2023.28.48.2300173"},{"key":"2026022706501256000_rapm-2025-107556v1.10","doi-asserted-by":"crossref","DOI":"10.1038\/s41467-024-46497-0","article-title":"Impact of vaccination on the association of COVID-19 with cardiovascular diseases: An OpenSAFELY cohort study","volume":"15","author":"Cezard","year":"2024","journal-title":"Nat Commun"},{"key":"2026022706501256000_rapm-2025-107556v1.11","doi-asserted-by":"crossref","unstructured":"Chuaychoosakoon C , Parinyakhup W , Tanutit P , et al . Shoulder injury related to Sinovac COVID-19 vaccine: A case report. Annals of Medicine & Surgery 2021;68. doi:10.1016\/j.amsu.2021.102622","DOI":"10.1016\/j.amsu.2021.102622"},{"key":"2026022706501256000_rapm-2025-107556v1.12","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1159\/000521785","article-title":"Uveitis after COVID-19 Vaccination","volume":"13","author":"Hwang","year":"2022","journal-title":"Case Rep Ophthalmol"},{"key":"2026022706501256000_rapm-2025-107556v1.13","doi-asserted-by":"crossref","DOI":"10.1016\/j.idcr.2022.e01475","article-title":"Fasciitis of the lower leg after COVID-19 vaccination","volume":"28","author":"Ide","year":"2022","journal-title":"IDCases"},{"key":"2026022706501256000_rapm-2025-107556v1.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.02.003"},{"key":"2026022706501256000_rapm-2025-107556v1.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2024.102809","article-title":"Cardiac manifestations and outcomes of COVID-19 vaccine-associated myocarditis in the young in the USA: longitudinal results from the Myocarditis After COVID Vaccination (MACiV) multicenter study","volume":"76","author":"Jain","year":"2024","journal-title":"EClinicalMedicine"},{"key":"2026022706501256000_rapm-2025-107556v1.16","doi-asserted-by":"crossref","first-page":"623","DOI":"10.2147\/JPR.S302115","article-title":"Recommendations and Guidance for Steroid Injection Therapy and COVID-19 Vaccine Administration from the American Society of Pain and Neuroscience (ASPN)","volume":"14","author":"Chakravarthy","year":"2021","journal-title":"JPR"},{"key":"2026022706501256000_rapm-2025-107556v1.17","unstructured":"United States National Library of Medicine . A study of Ad26.COV2. S for the prevention of SARS-CoV-2-mediated COVID-19 in adult participants (ENSEMBLE). 2020. Available: https:\/\/www.clinicaltrials.gov\/study\/NCT04505722 [Accessed 24 Nov 2025]."},{"key":"2026022706501256000_rapm-2025-107556v1.18","unstructured":"Centers for Disease Control and Prevention . Recommendations of the Advisory Committee on Immunization Practices (ACIP): Use of vaccines and immune globulins in persons with altered immunocompetence. MMWR 1993;42."},{"key":"2026022706501256000_rapm-2025-107556v1.19","unstructured":"Oliver S . ACIP data and clinical considerations for additional doses in immunocompromised. Available: https:\/\/stacks.cdc.gov\/view\/cdc\/108885 [Accessed 24 Nov 2025]."},{"key":"2026022706501256000_rapm-2025-107556v1.20","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1093\/cid\/ciab438","article-title":"The Effectiveness of the Two-Dose BNT162b2 Vaccine: Analysis of Real-World Data","volume":"74","author":"Chodick","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2026022706501256000_rapm-2025-107556v1.21","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.05.044"},{"key":"2026022706501256000_rapm-2025-107556v1.22","doi-asserted-by":"crossref","unstructured":"Tenforde MW , Patel MM , Ginde AA , et al . Effectiveness of sars-cov-2 mrna vaccines for preventing covid-19 hospitalizations in the united states. Infectious Diseases (except HIV\/AIDS) [Preprint]. doi:10.1101\/2021.07.08.21259776","DOI":"10.1101\/2021.07.08.21259776"},{"key":"2026022706501256000_rapm-2025-107556v1.23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2022.40.4_suppl.012"},{"key":"2026022706501256000_rapm-2025-107556v1.24","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker427"},{"key":"2026022706501256000_rapm-2025-107556v1.25","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1002\/1529-0131(199810)41:10<1828::AID-ART15>3.0.CO;2-T","article-title":"Antigen-specific antibody responses in lupus patients following immunization","volume":"41","author":"Battafarano","year":"1998","journal-title":"Arthritis Rheum Oct"},{"key":"2026022706501256000_rapm-2025-107556v1.26","doi-asserted-by":"crossref","unstructured":"Deepak P , Kim W , Paley MA , et al . Glucocorticoids and b cell depleting agents substantially impair immunogenicity of mrna vaccines to sars-cov-2. Infectious Diseases (except HIV\/AIDS) [Preprint]. doi:10.1101\/2021.04.05.21254656","DOI":"10.1101\/2021.04.05.21254656"},{"key":"2026022706501256000_rapm-2025-107556v1.27","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3344\/kjp.2022.35.1.14","article-title":"Steroid injections in pain management: influence on coronavirus disease 2019 vaccines","volume":"35","author":"Hong","year":"2022","journal-title":"Korean J Pain"},{"key":"2026022706501256000_rapm-2025-107556v1.28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3344\/kjp.2022.35.1.1","article-title":"Timing of musculoskeletal steroid injections in pain practice during Coronavirus disease 2019 (COVID-19) vaccine administration","volume":"35","author":"Kim","year":"2022","journal-title":"Korean J Pain"},{"key":"2026022706501256000_rapm-2025-107556v1.29","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1001\/jama.2025.5485","article-title":"Adrenal Insufficiency in Adults","volume":"334","author":"Vaidya","year":"2025","journal-title":"JAMA"},{"key":"2026022706501256000_rapm-2025-107556v1.30","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-015-0663-9","article-title":"Pneumococcal polysaccharide vaccination in adults undergoing immunosuppressive treatment for inflammatory diseases--a longitudinal study","volume":"17","author":"Fischer","year":"2015","journal-title":"Arthritis Res Ther"},{"key":"2026022706501256000_rapm-2025-107556v1.31","doi-asserted-by":"crossref","first-page":"3309","DOI":"10.1016\/j.vaccine.2013.05.004","article-title":"Hepatitis B virus vaccination in children with steroid sensitive nephrotic syndrome: Immunogenicity and safety?","volume":"31","author":"Y\u0131ld\u0131z","year":"2013","journal-title":"Vaccine (Auckl)"},{"key":"2026022706501256000_rapm-2025-107556v1.32","first-page":"389","article-title":"The effect of steroids for shock on the immune response to tetanus toxoid","volume":"53","author":"Johnson","year":"1987","journal-title":"Am Surg"},{"key":"2026022706501256000_rapm-2025-107556v1.33","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.152.12.1191"},{"key":"2026022706501256000_rapm-2025-107556v1.34","doi-asserted-by":"crossref","DOI":"10.1200\/GO.23.00458","article-title":"Effect of Corticosteroid on Immunogenicity of SARS-CoV-2 Vaccines in Patients With Solid Cancer","volume":"10","author":"Samdaengpan","year":"2024","journal-title":"JCO Glob Oncol"},{"key":"2026022706501256000_rapm-2025-107556v1.35","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/j.1526-4610.2001.01165.x","article-title":"Cushing syndrome induced by serial occipital nerve blocks containing corticosteroids","volume":"41","author":"Lavin","year":"2001","journal-title":"Headache"},{"key":"2026022706501256000_rapm-2025-107556v1.36","doi-asserted-by":"publisher","DOI":"10.1136\/ard.38.1.36"},{"key":"2026022706501256000_rapm-2025-107556v1.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80183-1"},{"key":"2026022706501256000_rapm-2025-107556v1.38","doi-asserted-by":"publisher","DOI":"10.1002\/art.20884"},{"key":"2026022706501256000_rapm-2025-107556v1.39","doi-asserted-by":"publisher","DOI":"10.1136\/ard.40.6.571"},{"key":"2026022706501256000_rapm-2025-107556v1.40","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1986.45"},{"key":"2026022706501256000_rapm-2025-107556v1.41","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1007\/BF02042771","article-title":"Adrenocortical function and responsiveness to tetracosactrin infusions after intra-articular treatment with triamcinolone acetonide and hydrocortisone acetate","volume":"1","author":"Esselinckx","year":"1982","journal-title":"Clin Rheumatol"},{"key":"2026022706501256000_rapm-2025-107556v1.42","first-page":"1691","article-title":"Polyarticular corticosteroid injection versus systemic administration in treatment of rheumatoid arthritis patients: a randomized controlled study","volume":"32","author":"Furtado","year":"2005","journal-title":"J Rheumatol"},{"key":"2026022706501256000_rapm-2025-107556v1.43","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.041525"},{"key":"2026022706501256000_rapm-2025-107556v1.44","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-013-2374-4"},{"key":"2026022706501256000_rapm-2025-107556v1.45","doi-asserted-by":"publisher","DOI":"10.2310\/JIM.0000000000000048"},{"key":"2026022706501256000_rapm-2025-107556v1.46","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0b013e31805468d6"},{"key":"2026022706501256000_rapm-2025-107556v1.47","first-page":"29","article-title":"Duration of action of epidural methyl prednisolone. A study in patients with the lumbosciatic syndrome","volume":"53","author":"Burn","year":"1974","journal-title":"Am J Phys Med"},{"key":"2026022706501256000_rapm-2025-107556v1.48","first-page":"E991","article-title":"Hypothalamic Pituitary Adrenocortical Axis Suppression following a Single Epidural Injection of Methylprednisolone Acetate","volume":"20","author":"Abdul","year":"2017","journal-title":"Pain Physician"},{"key":"2026022706501256000_rapm-2025-107556v1.49","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001158"},{"key":"2026022706501256000_rapm-2025-107556v1.50","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199409000-00017"},{"key":"2026022706501256000_rapm-2025-107556v1.51","doi-asserted-by":"publisher","DOI":"10.1136\/ard.39.1.22"},{"key":"2026022706501256000_rapm-2025-107556v1.52","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1055\/s-2008-1070385","article-title":"Plasmakonzentration und systemische Wirkung von Betamethason nach intraartikul\u00e4rer Injektion","volume":"106","author":"Gless","year":"1981","journal-title":"Dtsch med Wochenschr"},{"key":"2026022706501256000_rapm-2025-107556v1.53","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s40268-021-00348-1","article-title":"Safety and Systemic Exposure of Triamcinolone Acetonide Following Ultrasound-Guided Intra-Articular Injection of Triamcinolone Extended-Release or Standard Triamcinolone Acetonide in Patients with Shoulder Osteoarthritis: An Open-Label, Randomized Study","volume":"21","author":"Hanson","year":"2021","journal-title":"Drugs R D"},{"key":"2026022706501256000_rapm-2025-107556v1.54","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1111\/papr.12686","article-title":"Corticosteroid and Cortisol Serum Levels Following Intra-articular Triamcinolone Acetonide Lumbar Facet Joint Injections","volume":"18","author":"Dickson","year":"2018","journal-title":"Pain Pract"},{"key":"2026022706501256000_rapm-2025-107556v1.55","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000333"},{"key":"2026022706501256000_rapm-2025-107556v1.56","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/8474127","article-title":"Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection","volume":"2018","author":"Lamer","year":"2018","journal-title":"Pain Res Manag"},{"key":"2026022706501256000_rapm-2025-107556v1.57","first-page":"1","article-title":"Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010","volume":"59","author":"Fiore","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2026022706501256000_rapm-2025-107556v1.58","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110721"},{"key":"2026022706501256000_rapm-2025-107556v1.59","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2334-9-207","article-title":"Performance of the tuberculin skin test and interferon-gamma release assay for detection of tuberculosis infection in immunocompromised patients in a BCG-vaccinated population","volume":"9","author":"Kim","year":"2009","journal-title":"BMC Infect Dis"},{"key":"2026022706501256000_rapm-2025-107556v1.60","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1302\/2633-1462.19.BJO-2020-0130.R1","article-title":"Corticosteroid injections during the COVID-19 pandemic: experience from a UK centre","volume":"1","author":"McKean","year":"2020","journal-title":"Bone Jt Open"},{"key":"2026022706501256000_rapm-2025-107556v1.61","doi-asserted-by":"crossref","DOI":"10.1155\/2021\/8863210","article-title":"Musculoskeletal Corticosteroid Injection during COVID-19 Pandemic in Sabah: Is It Safe?","volume":"2021","author":"Azwan Aziz","year":"2021","journal-title":"Adv Orthop"},{"key":"2026022706501256000_rapm-2025-107556v1.62","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jor.2021.07.017","article-title":"Musculoskeletal steroid injections during the COVID-19 pandemic","volume":"26","author":"Bugeja","year":"2021","journal-title":"J Orthop"},{"key":"2026022706501256000_rapm-2025-107556v1.63","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00256-020-03656-w","article-title":"Symptomatic COVID-19 infections in outpatient image-guided corticosteroid injection patients during the lockdown phase","volume":"50","author":"Chang","year":"2021","journal-title":"Skeletal Radiol"},{"key":"2026022706501256000_rapm-2025-107556v1.64","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1002\/msc.1707","article-title":"Steroid injections in musculoskeletal conditions and COVID infection rates: What is the impact on positive rates following the injection?","volume":"21","author":"Lethbridge","year":"2023","journal-title":"Musculoskeletal Care"},{"key":"2026022706501256000_rapm-2025-107556v1.65","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/PHM.0000000000002147","article-title":"Incidence and Disease Course of COVID-19 Infection Among Unvaccinated Patients Who Received Local Corticosteroid Injections","volume":"102","author":"Ok\u00e7u","year":"2023","journal-title":"Am J Phys Med Rehabil"},{"key":"2026022706501256000_rapm-2025-107556v1.66","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.mayocpiqo.2018.01.005","article-title":"Joint Corticosteroid Injection Associated With Increased Influenza Risk","volume":"2","author":"Sytsma","year":"2018","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"2026022706501256000_rapm-2025-107556v1.67","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1093\/pm\/pnaa199","article-title":"Corticosteroid Injections and COVID-19 Infection Risk","volume":"21","author":"Miller","year":"2020","journal-title":"Pain Med"},{"key":"2026022706501256000_rapm-2025-107556v1.68","unstructured":"International Pain and Spine Intervention Society . Corticosteroid injections and mrna covid-19 vaccines. 2021. Available: https:\/\/www.ipsismed.org\/news\/news.asp?id=551084 [Accessed 31 Jul 2025]."},{"key":"2026022706501256000_rapm-2025-107556v1.69","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1111\/papr.13062","article-title":"The COVID-19 vaccine and interventional procedures: Exploring the relationship between steroid administration and subsequent vaccine efficacy","volume":"21","author":"Chow","year":"2021","journal-title":"Pain Pract"},{"key":"2026022706501256000_rapm-2025-107556v1.70","unstructured":"ARMA . Principles for COVID-19 vaccination in musculoskeletal and rheumatology for clinicians. 2022. Available: https:\/\/arma.uk.net\/covid-19-vaccination-and-msk\/ [Accessed 31 Jul 2025]."},{"key":"2026022706501256000_rapm-2025-107556v1.71","unstructured":"British Society of Skeletal Radiologists . The safety of corticosteroid injections during the COVID-19 global pandemic. 2020. Available: https:\/\/bssr.org.uk\/position-and-policy\/safety-msk-corticosteroid-injections-covid19 [Accessed 31 Jul 2025]."},{"key":"2026022706501256000_rapm-2025-107556v1.72","unstructured":"American Academy of Orthopaedic Surgeons . Guidance summary: use of corticosteroids for musculoskeletal pain during the COVID-19 pandemic. Available: https:\/\/www.aaos.org\/globalassets\/quality-and-practice-resources\/patient-safety\/covid-19\/steroid-injections-and-covid-19-guidance-document.pdf [Accessed 31 Jul 2025]."},{"key":"2026022706501256000_rapm-2025-107556v1.73","doi-asserted-by":"publisher","DOI":"10.1002\/pros.20847"},{"key":"2026022706501256000_rapm-2025-107556v1.74","doi-asserted-by":"crossref","DOI":"10.1016\/j.jvacx.2024.100452","article-title":"Outlining recent updates on influenza therapeutics and vaccines: A comprehensive review","volume":"17","author":"Malik","year":"2024","journal-title":"Vaccine X"},{"key":"2026022706501256000_rapm-2025-107556v1.75","doi-asserted-by":"crossref","first-page":"83","DOI":"10.15585\/mmwr.mm7406a2","article-title":"Interim Estimates of 2024\u20132025 Seasonal Influenza Vaccine Effectiveness \u2014 Four Vaccine Effectiveness Networks, United States, October 2024\u2013February 2025","volume":"74","author":"Frutos","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026022706501256000_rapm-2025-107556v1.76","doi-asserted-by":"crossref","first-page":"126073","DOI":"10.1016\/j.vaccine.2024.06.040","article-title":"Winter 2022-23 influenza vaccine effectiveness against influenza-related hospitalised aLRTD: A test-negative, case-control study","volume":"42","author":"Chatzilena","year":"2024","journal-title":"Vaccine (Auckl)"},{"key":"2026022706501256000_rapm-2025-107556v1.77","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1001\/jama.2025.5646","article-title":"Immunogenicity and Safety of Influenza and COVID-19 Multicomponent Vaccine in Adults \u226550 Years: A Randomized Clinical Trial","volume":"333","author":"Rudman Spergel","year":"2025","journal-title":"JAMA"},{"key":"2026022706501256000_rapm-2025-107556v1.78","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/j.vaccine.2005.10.007","article-title":"Impact of corticosteroids on the immune response to a MF59-adjuvanted influenza vaccine in elderly COPD-patients","volume":"24","author":"de Roux","year":"2006","journal-title":"Vaccine (Auckl)"},{"key":"2026022706501256000_rapm-2025-107556v1.79","first-page":"760","article-title":"Influence of corticosteroid therapy on the serum antibody response to influenza vaccine in elderly patients with chronic pulmonary diseases","volume":"12","author":"Inoue","year":"2013","journal-title":"EXCLI J"},{"key":"2026022706501256000_rapm-2025-107556v1.80","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.spinee.2022.01.014","article-title":"Spinal region corticosteroid injections are not associated with increased risk for influenza","volume":"22","author":"Sytsma","year":"2022","journal-title":"Spine J"},{"key":"2026022706501256000_rapm-2025-107556v1.81","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/j.spinee.2022.02.006","article-title":"Spinal corticosteroid injections are not associated with increased influenza risk","volume":"22","author":"Rittenberg","year":"2022","journal-title":"Spine J"},{"key":"2026022706501256000_rapm-2025-107556v1.82","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1097\/PHM.0000000000002236","article-title":"Odds of Influenza in Patients Receiving Intra-articular Corticosteroid Injections: A Cohort Study","volume":"102","author":"Sytsma","year":"2023","journal-title":"Am J Phys Med Rehabil"},{"key":"2026022706501256000_rapm-2025-107556v1.83","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2013.07.002"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2025-107556","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:50:24Z","timestamp":1772203824000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2025-107556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":83,"alternative-id":["10.1136\/rapm-2025-107556"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2025-107556","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}