Shingles vaccine--Has anyone had the shingles vaccine while taking methotrexate? Is it okay to do so?

[shareasmile]

[Barrister]

I haven't had the vaccine yet, but as far as I know, it is alright to have it whilst taking MTX but obviously check with your doctor. Clemmie

[Hidden]

I'm pretty sure it's a live vaccine, so I would err on the side of caution and say probably not but check with your rheum/rheum nurse.

[shareasmile in reply to Hidden]

Yes, it is live. My Rheumy said it was okay. My pharmacist raised caution. Hmmm.

[Hidden in reply to shareasmile]

While I hugely respect rheumatologists, I tend to trust pharmacists more about this sort of thing because they are the experts in pharmacology.

[Sunflower62]

Is this a new

[shareasmile in reply to Sunflower62]

I think the shingles vaccine is new within the last several years, but don't know for sure. It is recommended in the US for people age 60+ that have had chicken pox. I am only 50, but have had shingles and don't want to again--especially with a lowered immune system. I thought it would be a good idea. But, now I am not sure. =/

[BoneyC]

On my last two letters from Rheumatologist to GP there has been a highlighted paragraph reading:-

"Please note that the new shingles vaccine is live and, therefore, both this and the combined flu and shingles (herpes zoster) vaccine are NOT suitable for patients on Biologic immunosuppressive agents (anti-TNF agents, rituximab, tocilizumab, abatacept). Please could you arrange standalone flu vaccination, if required, in this patient."

[shareasmile in reply to BoneyC]

Yes, that is what I was told by my Rheumy. He said if I want the vaccine, I should get it before starting remicade. But the pharmacist expressed concern.

[Gracelet]

OMGoodness! Do you know what they put into these vaccines? With the immune system already suppressed by MTX I would steer clear of ALL vaccines, even the flu jabs. Your body has enough to deal with, without overloading it with more to cope with. When I was on methotrexate I concentrated on eating fresh fruit and vegetables, reducing my acid intake - even drinking alkaline water - and reducing as much stress as possible. It helped me enough to come off MTX. Hope you can find peace x

[Hidden]

There is absolutely no reason to steer clear of flu jabs unless advised to do so by your GP. I think you should discuss the shingles vaccine with your specialist nurse/GP and make your decision based on their advice.

[shareasmile in reply to Hidden]

My Rheumy was fairly adamant about the flu shot, so I received that without any trouble.

[shareasmile]

Thanks everyone! I see a new Rheumy next month and will ask him. I have had shingles before, prior to RA, and want to avoid them again, if possible. I was told that the vaccine with low dose MTX was okay, but if I were to start a biological--which is my next step, I should get the vaccine first. My pharmacist advised against the vaccine as it is live and could cause a bout of shingles while on MTX. So confused!

[allanah]

Grace, im afraid i dont agree with ou but am willing to debate! your body can cope with lots of germs, how many do you think you get just touching a door handle! Millions if not billions, so a few from vaccines is totally acceptable I think personally, particularly baby vaccines. When you see what can happen to unvaccinated children I am so glad we live in the uk with free vaccines. So as you can see I am a great supporter of vaccines! I totally respect your freedom of choice though. Hand washing is also very important.

However the point that you can't have live vaccines on biologicals and live vaccines like Yellow Fever stands I believe , always inform the staff of which medicines you are on prior to having vaccines.

[sparkymac]

I had the shingles vaccine last year whilst taking 10mg MTX once a week. No apparent side effects that I'm aware of, apart from not getting shingles, of course. Good luck. If in doubt, have a word with your practice nurse or doctor.

[catzzz]

I actually got my shingles shot a month before i started methotrexate and at that time i was taking 10mg of prednisone. I have had no issues since i had the shot back in May. Talk to your doctor, there are some studies that have and are being done in regards to this. my heart goes out to you.

[KaysDad]

I was concerned about this, but decided to go ahead when I read the NHS statement on this (Dated July 2013).

"Therapy with low-doses of methotrexate (<0.4 mg/kg/week), azathioprine (<3.0 mg/kg/day), or 6mercaptopurine (<1.5 mg/kg/day) for treatment of rheumatoid arthritis, psoriasis, polymyositis, sarcoidosis, inflammatory bowel disease, and other conditions are not considered sufficiently immunosuppressive and are not contraindications for administration of zoster vaccine."

So, if you can work out what your weekly dose is and divide that by your weight in kg, you should be able to determine whether it is OK for you, according to the NHS. It was fine for me - so I went ahead without any side effects.

[shareasmile]

Thanks Richard! I ended up stopping my RD meds for 2 weeks, got my jabs for pneumonia and singles, and then started Humira. I have since changed to Enbrel with good results and had no problems with the vaccines.