Analgesia & COVID Vaccination

NSAIDS May Impair Host Defenses

The preference for the use of non-opioid analgesics for pain should now be obvious.   However as the option of public COVID-19 vaccination is now widely available in many states, practitioners should be cautioned about the routine use of NSAIDS for pain relief where their treatment may overlap a patient’s vaccination window.(1)

NSAIDs inhibit cyclooxygenase (COX) which plays a critical role in the prostaglandin mediated inflammatory process.  The COX enzyme system exists as isoforms COX1 and COX2 with COX2 being pro-inflammatory.  COX2 is also responsible for optimal for antibody production from B-lymphocytes.

The implication is that both non-selective inhibitors (COX1/COX2) – like ibuprofen – and selective inhibitors (COX2) – like celecoxib – after infection or any vaccination may impair host defenses – and probably should be avoided in favor of acetaminophen.

1.   Bancos S, Bernard MP, Topham DJ, Phipps RP. Ibuprofen and other widely used non-steroidal anti-inflammatory drugs inhibit antibody production in human cells. Cell Immunol. 2009;258(1):18-28. doi: 10.1016/j.cellimm.2009.03.007. Epub 2009 Apr 5. PMID: 19345936; PMCID: PMC2693360.

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