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DECEMBER 18, 2020


AJ van der Lely, MD, PhD

Erasmus University Medical Center

Rotterdam, Netherlands


Shlomo Melmed, MB, ChB

Cedars-Sinai Medical Center

Los Angeles, California

December 18, 2020


Dear Pituitary Society Colleagues,


In preparation for the upcoming COVID-19 vaccine, we surveyed our membership to understand planned approaches to glucocorticoid management in patients with adrenal insufficiency who will receive the vaccine.


We have received the results of the survey from 103 responders:


Thirty six percent plan to recommend that patients automatically increase their glucocorticoid dosage with administration of the first vaccine injection. Of these, 71% plan to increase the glucocorticoid dose on the day of the vaccination, and 40% plan to increase the glucocorticoid dose prior to the vaccination. In contrast, 64% do not plan to recommend an automatic glucocorticoid dose increase with vaccine administration. Of this group, 93% plan to increase the dose if the patient develops a fever following administration, and 55% plan to increase the dose if myalgias and arthralgias occur.


Thus, most clinicians, i.e. 64%, plan to maintain the current glucocorticoid dose with vaccine administration. The vast majority of such clinicians plan to increase the glucocorticoid dose with fever, and just over half plan to increase the dose with associated arthralgias and myalgias, known vaccine side effects.


These survey results offer a glimpse into the planned approach of our members for glucocorticoid management in patients with adrenal insufficiency. This survey does not reflect results of a trial on efficacy of glucocorticoid management in patients receiving the vaccine nor the impact of a particular glucocorticoid dose on the vaccine immune response.


Importantly, these results do offer suggested management guidance based on responses from experienced clinicians treating pituitary diseases worldwide.


Warmest wishes to all for a safe and healthy 2021!

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Laurence Katznelson, MD

8700 Beverly Blvd, Room 2051  |  Los Angeles, CA 90048  |  301-988-9486  |

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