Endocrine Society Joins ASBMR and Other Bone Health Organizations to Provide Advice on COVID-19 Vaccine and Osteoporosis



Newswise – WASHINGTON –As COVID-19 vaccines continue to be distributed, the world’s leading bone health research, clinical and patient advocacy organizations ASBMR, Endocrine Society, AACE, ECTS, NOF and IOF provide recommendations to help clinicians manage osteoporosis treatments for their patients who are planning to be vaccinated. The full guidance document with supporting evidence is available at https://www.asbmr.org/about/statement-detail/joint-guidance-on-covid-19-vaccine-osteoporosis

Experts agree that there is no evidence that treatment for osteoporosis increases the risk or severity of COVID-19 infection, changes the course of the disease, or interferes with the effectiveness or the COVID-19 vaccination side effect profile. However, given the limited availability of the COVID-19 vaccine, vaccinations may need to be prioritized and changes made to standard osteoporosis treatment regimens. Patients are advised to consult their health care providers before making any changes to osteoporosis regimens. General bone health measures (i.e., calcium and vitamin D supplementation, weight-bearing exercises, and maintenance of a balanced diet) should not be discontinued at or after vaccination.

“The rapid deployment of the COVID-19 vaccine has raised questions about integrating vaccine delivery with ongoing osteoporosis treatment,” said ASBMR President Suzanne Jan De Beur, MD. It is easier for healthcare professionals and their patients to understand the best approach to adjusting treatment regimens for osteoporosis while getting vaccinated.

Drug-specific recommendations for the management of patients with osteoporosis in relation to vaccination against COVID-19

Oral bisphosphonates [alendronate (Fosamax®), risedronate (Actonel®), and ibandronate (Boniva®)]

  • Oral bisphosphonates should be continued in patients receiving COVID-19 vaccination.

Intravenous (IV) bisphosphonates [zoledronic acid (Reclast®) and ibandronate (Boniva®)]

  • An interval of one week (at least four days) is recommended between IV bisphosphonate infusion and COVID-19 vaccination to help distinguish between autoimmune or inflammatory reactions resulting from either IV bisphosphonate administration or of COVID-19 vaccination.

Denosumab (Prolia®)

  • An interval of 4 to 7 days between treatment with denosumab and vaccination against COVID-19 is recommended to allow the potential occurrence of injection site reactions with either treatment. Alternatively, denosumab treatment could be given to the contralateral arm or another site (abdomen or upper thigh) if it is necessary to be administered at the same time as the COVID-19 vaccine. Although the denosumab schedule may be adjusted slightly to accommodate the vaccination schedule, denosumab injections should not be delayed for more than 7 months after the previous dose of denosumab.

Teriparatide (Forteo®) or abaloparatide (Tymlos®)

  • Teriparatide and abaloparatide should be continued in patients receiving COVID-19 vaccination.

Romosozumab (Evenity®)

  • Wait 4-7 days between injections or consider injection into the abdomen (except for a two-inch area around the navel) or thigh if co-administered.


  • Raloxifene should be continued in patients receiving COVID-19 vaccination.

Osteoporosis on its own does not appear to increase the risk of infection or complications from COVID-19. Therefore, it is not necessary to prioritize patients with osteoporosis for COVID-19 vaccination solely on the basis of this condition. However, any decision to prioritize patients with osteoporosis for vaccination should be based on country-specific indications.

The complete guide to COVID-19 vaccination and osteoporosis management is available here.


Endocrinologists are at the heart of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists in hormonal research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of Endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.


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