In general, there are two groups of vaccines. The first are live attenuated vaccines (this includes live bacteria or virus that have lost their power to trigger disease) and inactive or recombinant vaccines (includes killed dead organisms or simply some of their components in a pure form).

Live attenuated vaccines Inactivated or recombinant
Yellow fever Mumps Measles Rubella Tuberculosis Varicella Tetanus Diphtheria Meningococcal Poliomyelitis Flu Hepatitis A Hepatitis B Pneumococcal Typhoid fever Haemophilus

Live attenuated vaccines are generally not recommended in patients who take cortisone orally, intramuscularly or via intravenous routes. The U.S. Department of Health believes that this holds especially true for patients receiving more than 20 mg per day of prednisone for longer than two weeks. It is therefore recommended to wait a few weeks after stopping corticosteroids before using such a vaccine. Inactive or recombinant vaccines can be used safely in patients treated with cortisone. Although your immune response could be modified, corticosteroid therapy does not inhibit the effectiveness of these vaccines. According to many national and international recommendations, patients exposed for systemic glucocorticoids for several weeks or months should be adequately vaccinated against influenza and pneumococcus.

Useful references
  • Abu-Shakra M et al. Influenza vaccination of patients with systemic lupus erythematosus: safety and immunogenecity issues. Autoimmun Rev. 2007
  • Wasan SK et al. A practical guide to vaccinating the inflammatory bowel disease patient. Am J Gastroenterol. 2010
  • Busse WW et al. Vaccination of patients with mild and severe asthma with a 2009 pandemic H1N1 influenza virus vaccine. J Allergy Clin Immunol. 2011
  • Chalmers A et al. Immunization of patients with rheumatoid arthritis against influenza: a study of vaccine safety and immunogenicity. J Rheumatol. 1994
  • Lipnick RN et al. Pneumococcal immunization in patients with systemic lupus erythematosus treated with immunosuppressives. J Rheumatol. 1985