Coronavirus Vaccines and Adrenal Insufficiency

Updated September 2025

Here we cover the coronavirus vaccine and answer the most common questions from the Addison's and adrenal insufficiency community. If you would like more information on coronavirus, including dosing guidance, please visit our main coronavirus page.

On this page:

It is safe for people with Addison's and adrenal insufficiency to have a COVID vaccine?

It is safe for those who have a steroid-dependent adrenal condition to receive the coronavirus vaccine and boosters to reduce their risk of getting coronavirus, unless specifically advised otherwise by their medical team due to their personal medical circumstances. 

A vaccine is an effective way to prevent infection and lower your risk of becoming seriously ill from coronavirus. 

Can vaccines cause bad reactions?

We are all different and some people may have a reaction, for example due to an allergy to the ingredients. Always ask your healthcare professionals to discuss the ingredients with you to make sure you are comfortable. For any individual circumstances, for example any conditions you have alongside adrenal insufficiency, always speak with your healthcare team.

For any further concerns you have, to find out more about reactions to vaccines and the Yellow Card scheme for reporting reactions, please visit the NHS website.

NHS: Vaccines

Are people with adrenal insufficiency at greater risk of bad reactions to vaccines? 

People with adrenal insufficiency are not at an increased risk of having bad reactions to vaccines - but everybody is different, so this will depend on your individual circumstances. Lots of factors at the time of having the vaccine may make it appear a bad reaction is related to the vaccine such as food poisoning or a stomach bug. As with all bouts of illness or physical stress on your body, you should follow the sick day rules. 

If you feel unwell after a vaccination:

  • Check if you have an allergy to any ingredients in the vaccine
  • Increase your glucocorticoid as you would normally for the sick day rules
  • Take paracetamol to help reduce your symptoms making them easier to manage
  • Rest and drink plenty of fluids

Fludrocortisone and the COVID vaccines: Some members have been in touch concerned having read online that you should not have vaccinations if taking fludrocortisone. Our medics have confirmed these rumours are incorrect. When taking fludrocortisone as replacement therapy for Addison's or any form of adrenal insufficiency, you should still receive vaccinations when offered by your healthcare professionals.

UK COVID booster programmes

If you have adrenal insufficiency, including Addison’s, you are no more likely to catch coronavirus (COVID-19) than anyone else. However people with adrenal insufficiency, including Addison’s, are more vulnerable to become severely unwell triggering an adrenal crisis, if they do get coronavirus, but the way it affects you can vary from person to person.

During the peak of the pandemic, those with Addison's and adrenal insufficiency were eligible for the free COVID vaccines and boosters, alongside other chronic conditions such as diabetes. You can read more about this in our News item here. Vaccines and boosters are effective ways to prevent infection and we encouraged those eligible to get vaccines and boosters when offered. 

From Autumn 2025, only the following groups of people will be offered a COVID-19 vaccination in the UK: 

  • adults aged 75 years and over
  • residents in a care home for older adults 
  • individuals aged 6 months and over who are immunosuppressed.

The Joint Committee on Vaccination and Immunisation (JCVI), which advises the government on vaccines, explains that since the pandemic began, vaccines and boosters have built strong protection across the population to the virus that causes COVID-19.  The rates of serious illness and hospitalisation from coronavirus have significantly reduced, despite some groups of people being at higher risk of more severe infection. Therefore due to the high population immunity to COVID-19, the eligibility for free NHS COVID boosters has been changed.

This means that all children and adults in the UK living with long-term health conditions, including Addison’s and adrenal insufficiency, who do not fall into one of the three groups listed above, will no longer be offered a free NHS COVID-19 vaccination.

For more information see the NHS website: COVID-19 vaccine - NHS

Steroids taken for adrenal insufficiency are replacement doses and increasing the dose during illness is to try and mimic your body's natural physiological response. In the correctly tailored dosages, they should not suppress your immune system or make you more susceptible to infection. Learn more on our medication page. However if you feel you should qualify for the immunosuppressed group to the level of steroids you take, please contact your healthcare team.

This does not affect flu jab eligibility and people living with adrenal insufficiency, including Addison’s, will still be offered a winter flu jab as normal.

Private COVID booster vaccines remain available

COVID booster vaccines are available privately from most local pharmacies as well as larger pharmacies such as Boots and are safe to have at the same time as your flu jab, although it is advised to have them in different arms. If you are worried you may like to consider paying for a private COVID booster vaccine.

    If you're a healthcare professional, please visit the Society for Endocrinology for more information.

    Booking a COVID vaccine

    If you are eligible, you can book your vaccine online. Visit the NHS website to find out more.

    NHS COVID-19 vaccination appointment

    For those not eligible, COVID booster vaccines are available privately from most local pharmacies as well as larger pharmacies such as Boots. If you are worried you may like to consider paying for a private COVID booster vaccine.

    Should I increase my glucocorticoid dose before having the COVID vaccine or booster?

    Our Addison's Clinical Advisory Panel (CAP) and Society for Endocrinology have advised that there is no need to routinely increase glucocorticoid dose in patients with adrenal insufficiency at the time of vaccination if no significant symptoms.

    If you are particularly anxious or stressed before, this will "use up" your cortisol so you should up-dose in response to how you feel. It's different for everyone, as every body is different - so please listen to your body and do what is right for you.

    If you feel unwell after a vaccination:

    • Check if you have an allergy to any ingredients in the vaccine
    • Increase your glucocorticoid as you would normally for the sick day rules
    • Take paracetamol to help reduce your symptoms making them easier to manage
    • Rest and drink plenty of fluids

    What does it feel like to receive the COVID vaccine when you have Addison's or adrenal insufficiency? 

    It's different for everyone, as shown in the experiences shared by ADSHG members in previous magazines and on our online forum. 

    If you feel unwell after a vaccination:

    • Check if you have an allergy to any ingredients in the vaccine
    • Increase your glucocorticoid as you would normally for the sick day rules
    • Take paracetamol to help reduce your symptoms making them easier to manage
    • Rest and drink plenty of fluids

    Side effects are a sign that your immune system is kicking into action to protect you from COVID-19 - this is not a COVID-19 illness and the vaccine can’t give you coronavirus. At the same time, don’t worry if you don’t experience any of these effects after your vaccine. Your immune system will still be learning to respond to the virus.

    Can I have the COVID-19 booster and flu jab at the same time?

    It is safe to have both vaccines together, but it is advised to get them in different arms. However there is no 'one size fits all' approach. If you're aware from experience that your body requires extra rest after vaccines, you may wish to leave a couple of days between vaccine appointments to suit your circumstances. Visit our 'Flu jab and other vaccines' page to learn more about the flu jab.

    On our online forum, members have been sharing their experiences of receiving both vaccines. So if you'd find it reassuring to hear others' experiences direct, please visit our online forum to join the conversation.

    Are people with Addison's and adrenal insufficiency immunocompromised? 

    People with Addison’s and adrenal insufficiency are not classified as having a severely weakened immune system or being immuno-suppressed, unlike for example, those with conditions such as blood cancer.

    People with Addison’s and adrenal insufficiency are on a low dose of replacement steroids – rather than on a high dose of steroids for immune suppressive purposes. Therefore the replacement steroids do not make the individual immuno-suppressed as the steroids are replacing what the body would naturally produce. 

    Whilst there is some research suggesting patients with Addison’s disease have a small increased risk of infections, this is not to the same degree as patients who are immunocompromised.  

    However, it is important to remember that those with Addison’s and adrenal insufficiency are unable to mount a response to infection without extra steroid medication. This is why people with Addison's and adrenal insufficiency are eligible for the free NHS flu vaccine. People with Addison’s and adrenal insufficiency benefit hugely from the protection provided by vaccines. 

    Learn more about steroid medication

    Emotional support

    You might be feeling worried and anxious about coronavirus. Please visit our webpage to help you cope with stress and other emotions. You can also connect with others on our online forum, where members share their experiences and advice, and you can ask any unanswered questions. You can also visit our sanctuary of support page to help if you feel lost, concerned, puzzled or poorly. 

    Whether you're newly diagnosed or have lived with the condition for years - please join our community and support our cause! You'll receive the latest expert advice, guidance and ADSHG news, whilst being part of our inspiring and supportive community. Become a member today! 

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    Author: Philippa Sharman

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