NRAS advice please

[cafbat]

There is much confusion re whether those of us on biologics will get a third jab or a booster, or a third jab then a booster! Certainly I am confused and I have heard nothing from my rheumatology team for a year. Can you provide us with any guidance please? Thank you in anticipation

[helixhelix]

Isn’t the only difference between them the timing? A third jab is something given within a fairly short interval after the second one (12 weeks maybe?). And a booster is something given after 6 months have elapsed. What goes into your arm is the same.

That’s what I had gathered but could wrong!!

(And that it is steroids, rituximab and MTX that are the issues - not biologics)

[Mmrr in reply to helixhelix]

My understanding too about boosters / 3rd jabs. JAK inhibitors have also been flagged up as a problem with developing antibodies too.

[AgedCrone in reply to helixhelix]

I agree…Looks like in U.K. everyone 50+ is going to be offered a 3rd jab….but not until 6 months post their second vaccination.Presumably all those extremely vulnerable ie 70/80+ transplant patients & some HIV & cancer patients on chemo will not have to wait..but I didn’t hear anything about other less vulnerable groups today.

In fact I got the impression the scientists & the politicians are not exactly 100% in agreement…..so nothing new really!

[MadBunny in reply to helixhelix]

Thanks for explaining😁 I've been confused by the difference in the two but your reply has clarified it for me re timing.

[bpeal1 in reply to helixhelix]

You are right. 3rd primary dose can be given any time after 8 weeks from second dose, the booster must be at least 6 months. Those who have a third primary dose may also be offered a booster after 6 months.

For a comprehensive list of who is eligible for a third dose see my link below. It does include some of the biologics.

[Sheila_G]

My friend's rheumatologist told her that everyone on immunosuppressant drugs will be given a 3rd vaccine then a booster.

[helixhelix in reply to Sheila_G]

And did they explain whether there was any difference between them (apart from timing?)

[Sheila_G in reply to helixhelix]

I don't know actually. I will ask her and get back to you.

[Sheila_G in reply to Sheila_G]

The third dose is identical to the first two and helps to protect people with weakened immune systems who didn't have a strong enough response fo the first 2. The booster is an additional dose to help people fo maintain their level of immunity longer but time line I don't know.

[helixhelix in reply to Sheila_G]

Which also sounds as if they are the same thing (ie what’s in the syringe is identical).

I am trying to pin this down as due to have a jab next week and wamt to be sure it is right!

[Sheila_G in reply to helixhelix]

Absolutely. It is the same so we must have a 3rd vaccine then have a booster when the third starts fo wear off but how will they know that without giving us antibody tests? It is no different than us having 4 and everyone else having 3 or you could say the next jab is the same for everyone but for others it is called a booster and for us it is called a 3rd vaccine. Sounding more like a West End farce every minute.

[bpeal1 in reply to helixhelix]

For Astra Zeneca and Phizer what’s in the syringe is identical for both the 3rd dose and booster (although mRNA vaccines are the preference for both 3rd doses and boosters) The difference is timing, so for my daughter who is on biologics and due her second dose in October she’ll now get a third dose 8 weeks after that, for me as I had my second dose nearly 6 months ago it won’t make a huge difference, I’ll only get it a couple of weeks earlier.

For some reason (which I don’t really understand) Moderna is different. A 3rd dose of moderna should be a full dose but the booster can be a half dose.

[cafbat in reply to bpeal1]

That is really helpful, thanks

[Tile in reply to bpeal1]

Moderna 2 doses is 200 mcg that is more than 6 doses of Pfizer which is 180 mcg. 3 doses of Moderna is 300mcg which would be 10 doses of Pfizer. Moderna half dose will be 50mcg still more than one dose of Pfizer at 30 mcg. Moderna should be given to immunocompromised. Moderna has had better AB production in those over 65 it's obvious why.

[bpeal1]

Here is the letter sent to all consultants and GPs in the NHS about third primary doses. There is a list of who is eligible in the annex, I think most of us would be included in either section 2 or 3 .

england.nhs.uk/coronavirus/...

[cafbat in reply to bpeal1]

Thank you, that is really interesting. So that does clearly imply that there is a direction to give a third primary dose. I wonder therefore why so few of us have been contacted by our GP for our third jab!

[GinnyE in reply to bpeal1]

Thank you. I’ve also posted below the BSR advice.

[Lolabridge in reply to bpeal1]

Thank you for posting the link. It will be really helpful for me to show a copy of the letter to my GP when I see her on Monday.

[GinnyE]

Extract from the BSR advice:

“As a result, we advise that all patients on DMARDs (except HCQ and SSZ), biologics, JAK inhibitors, and those on prednisolone >10mg should have a third vaccine dose to enhance primary vaccination effectiveness. Rheumatology teams should share this information with their local primary care colleagues so these patients can be contacted to arrange an appointment for a third dose. “

The full document says that it would be too much of a task to go through each individuals case and therefore advises the above.

[Boxerlady in reply to GinnyE]

Interesting - I thought that you were only eligible if on Methotrexate doses above 20mg 🤔

[Cavlover in reply to Boxerlady]

Me too. I am on 20mg but have a low wbc so will have to see what happens. Not expecting to hear though.

[EmmaSpicer-NRAS]

Hi cafbat, thank you for your message. If you need anymore guidance, please feel free to call our helpline on 0800 298 7650 which is open between 9.30 am and 4.30pm every week day. Emma from NRAS.

[cafbat in reply to EmmaSpicer-NRAS]

Thanks Emma but I don’t need an individual answer. I think the responses on here show that there is general confusion about 3rd jabs vs boosters, so be great if NRAS could confirm some guidance via their webpage. For example, my GP says he knows nothing about 3rd doses, just boosters. Many thanks.