Nasal flu spray and metoject

[xxspoonerxx82]

Is it safe for my 10 year old son to have his nasal flu spray while I am on metoject? I have also been told I need to have a flu jab but I am worried.

[Hidden]

Hi SpoonerYou need to check with your rheumy dpt as we are not qualified to give you advice but I think your son will need to have the non live injection instead as the nasal spray is live. I've had flu Jabs yearly for 20 years and took Methotrexate without any issues. You don't want flu, it could make you very very ill.

Do you have an advice line at your rheumy dpt you can ring?

Kiki

[xxspoonerxx82 in reply to Hidden]

Yes, I'll give them a ring thank you

[nomoreheels]

This may be helpful: NRAS statement for those with RA who care for or are in close contact with school aged children who are being offered the Nasal Spray Flu vaccination.This is largely an "evidence free" zone and the advice that tends to be given is both overly conservative: "should not be in contact with anyone who is ‘immune compromised’ for two weeks" which is often impractical. Everyone living with RA is advised to have their flu vaccination as a matter of course anyway so if your child is about to have the live vaccine and you’ve had your own flu vaccine at least 2 weeks prior then this should give you adequate flu protection. However, the nasal flu vaccination spray does contain 4 strains of flu whereas the injectable contains just 3 strains.

Generally, the view is that someone on standard DMARDs (methotrexate, leflunomide, sulfasalazine, hydroxychloroquine) may NOT be regarded as immunocompromised but those on regular steroids of greater than 7.5mg daily or any biologic/biosimilar or small molecule therapy (JAK inhibitors), they should be regarded as "potentially immune compromised" for this purpose, especially also if over 70 years of age.

In summary, being aware and trying to take precautions ahead of being in close proximity to a vaccinated child is suggested. If you have already been in contact with a vaccinated child and are showing symptoms of flu don’t delay seeking medical advice from your GP or rheumatology team. Ideally get your own flu vaccine 2 weeks in advance of the child/children being vaccinated in school.

If you have any concerns, contact your rheumatology team for further advice. nras.org.uk/statement-about...

[xxspoonerxx82 in reply to nomoreheels]

Thank you

[nomoreheels in reply to xxspoonerxx82]

You're welcome. I’ve always had the flu jab, on my GP Practice's list so called each year to have it. That is except this year when, as recommended, I asked for both my h & myself to be added to the priority list & told I was on the second flu clinic list next month. I arranged for my Pharmacy to vaccinate us both & had it when the first batch came out. I'd urge to you seriously think about having it, more so this year, some cover is better than none with RD. If you haven’t had the pneumonia vaccine either I'd ask if you should have that too, both conditions have the ability to become serious without some protection.

[xxspoonerxx82 in reply to nomoreheels]

I've never had one. I've had the letters from my GP each year tho. I got a letter yesterday saying about my flu jab so I think I'm going to have it this winter. I now worried about my son having hes as hes got to have the injection instead of the nasal spray type 🙈 he hates needles x

[bpeal1 in reply to xxspoonerxx82]

Talk to your rheumatologist but he might not need the injection. Even though I’m on Rituximab both the school nurses and my rheumatologist were happy for my son to have the nasal spray. My teenage daughter has JIA and takes leflunomide (a DMARD with similar effects on the immune system to MXT) and the rheumatologist said it was absolutely fine for her to have the nasal spray too.

[nomoreheels in reply to xxspoonerxx82]

Going off the NRAS advice I'd say that you'll be fine with your son having the spray as you're not considered to be immunocompromised, that is if MTX is your only RD med & you're not taking prednisolone or other corticosteroid at >7.5mg. Plus he'll be better protected with the spray. Personally, I’d have my jab done 2 well at least prior to my son having the spray.

I hope there's no reason for you not to be vaccinated, more so this season. It you have any concerns though do please talk with your Rheumy.

[Domhem]

My daughter had the spray Tuesday and I had the vaccine three weeks ago to ensure I was protected, definitely make sure you’re all up to date on your jab and you leave at least two weeks between your injection and their spray x

[Littlemunch]

It is possible for your son to have a jab instead. My 3yr daughter just had jab after confirmation with Dr this would be best

[Hidden in reply to Littlemunch]

Read the nras guidance above. They are saying that it wasn't necessary for your daughter to have the jab 👍