Steroid impact on the efficacy and safety of SARS-CoV-2 vaccine: a systematic review

Background: The COVID-19 vaccine has become the utmost protection against the pandemic, with billions of doses has been used across the globe. Immunosuppression has been one of the leading issues in the vaccination program, one of which should not be handled lightly is the use of the steroid. Thus, this systematic review is aimed to explore the Impact of steroid use on the efficacy and safety of the COVID-19 vaccine. Methods: The systematic review is conducted based on the PRISMA guideline by conducting a literature search and screening process through several databases (PubMed, ScienceDirect, Scopus, and EBSCOHost) based on the predetermined PICO criteria. Original articles (Controlled trial or cohort) on the use of steroids in healthy or non-immunocompromised or autoimmune patients were included. The included articles were then assessed for risk of bias using the ROBINS-I tool. Results: 6,857 articles were screened, with two articles included for the final analysis. The results show a non-significant Impact of steroid use on the vaccine efficacy based on seropositivity and antibody count. However, steroid use is related to milder adverse effects and symptoms. Conclusion: Steroid is not associated with lower response to the COVID-19 vaccine. Further research on the dose-dependent response to steroid use should be conducted.