I only just had my first Abatacept injection 4 days ago and have just had the last of a course of steroids, so the immune system is low already (think I have a sinus infection 🙄).
Anyhoo…. My question is.. has anyone else stopped their weekly biologic injections to give the vaccines a chance to work? I’m about to have 3rd/booster covid jab and flu jab.
I read this article on Creaky Joints website, which I found helpful, but wanted to ask you experts if anyone had actually done this or would recommend.
I was advised to continue taking all meds leflunomide, toficitinib and daily prednisolone in case stopping them brought on a flare.The advice on the few NRAS updates that I have listened too, is to continue taking meds unless advised to stop by your rheumatologist. Even then different rheumatologists are recommending different things, depending upon their own views.
Hi. I have just had an appointment with my rheumatolgist today. She said it wasn't necessary to stop my Abatacept for either my flu or Covid vaccination. But if I am prescribed antibiotics then I should stop until I have finished the course. I do think, however, that some rheumatolgists differ in their opinion on the subject.
Thank you, that’s helpful. I’ve only taken one injection of Abatacept and I’m not feeling too well on it. Left side of face, eye, ear and throat are very sore to the touch & a bit swollen. How have you got on with it?
Oh really! That’s reassuring to hear thank you. I thought it might be to do with my sinuses 🤷 pharmacy today thought probably a reaction to Abatacept. Is that the biologic you’re on?
For me it's been fantastic but we're all different. I had a bad time with tocilizumab. Don't suffer for too long if you think it's causing you too much pain.
Hi, I’m on Abatacept and azathioprine. I didn’t stop either for my covid booster or flu jab. To be honest I couldn’t get hold of anyone to check so just thought to hell with it and have carried on as normal x
Hi I’m on Abatacept & was told to omit mine the past 2 weeks as had flu jab then a week later ( last week) had 3rd Covid vaccination. She did say there are no set rules as such but suggested that was best for me currently as I’m rather complex! Other than a sore arm I’ve been fine with both x
Hi, I did ask the question as I was due to take my Sarilumab on the Monday, and my 3rd Covid Vaccine was due the day after. The nurse said it was fine to delay my Sarilumab by a week so I did!
I am not a medical professional. I have not been advised to stop my weekly injection of Abatacept by my RA team in order to have my flu jab and covid booster jab. I am on my 22nd injection and did not stop my injections for my two covid jabs. I have just also had my flu jab - not a live vaccine and have not had any instructions to stop for my booster covid in November. My Ra team are on the ball so I am not worrying however I would advise you to speak to your RA team to clarify if you are in any need to stop your injections of Abatacept.
The covid vaccination relies on your immune response to make antibodies. We've been told due to us being immune suppressed our protection from the vaccines will not be as good as others. I took the decision not to have my RA drugs before and after having my vaccinations. I thought it was silly taking two lots of medication that suppresses my immune system, when the vaccine relied on my immune response. My consultant did tell me that from a clinical point of view there should be a five week window each side of having the vaccine. I've read now if possible to have a drug holiday. I was asked to do an at home covid antibody test which i did 5 weeks after having my second Pfizer vaccination, almost immediately the result was that I had long lasting antibodies.
This is part of what I've read in a letter sent to all GP practices.
In general, vaccines administered during periods of minimum immunosuppression (where possible) are more likely to generate better immune responses. The third primary dose should ideally be given at least 8 weeks after the second dose, with special attention paid to current or planned immunosuppressive therapies guided by the following principles:
• where possible, the third primary dose should be delayed until 2 weeks after the period of immunosuppression, in addition to the time period for clearance of the therapeutic agent
• if not possible, consideration should be given to vaccination during a treatment ‘holiday’ or at a nadir of immunosuppression between doses of treatment.
Regarding flu vaccination. I've had my third covid vaccine, I had my flu vaccination booked for the following day, I cancelled it. The covid vaccine relies on my immune response and I'm assuming the flu does as well. I just thought I'd give my immune system one vaccine at a time to deal with.
This is my opinion and I'm not advising anyone to do the same.
This is an email in reply to one of my nurse specialist asking her about having covid and flu vaccinations together.
Hi Paula,
Unfortunately, at the moment there is no research to suggest if having the covid booster and flu vaccination together as someone who is immunosuppressed will result in less protection or poor response.
It may be worth having one first and then waiting 2-3 weeks before the next to give your body chance to create antibodies and respond.
However, as mentioned we do not have any guidance in writing regarding this yet unfortunately.
hi just wanted to what an excellent response to han1's question. Informative and well written. interesting to read, this isn't a condition I have to worry about, but still interesting to see how people cope with different issues.
I've just had covid, been taking vitamin D for years when my partner got ill, I doubled up on my prescribed amount. thankfully I did as the second week of my illness was cut short when the extra vitamin D kicked in. that's the restricted breathing part of covid.
I smoked for around 48 years. and must say that I feel great. It's as if my body has had a string clean. my breathing is better than it's been for years.
I wanted to get across that covid isn't the end, as long as you are taking vitamin D, and had the vaccine if you felt you needed it. it's not something to live in fear of. common sense, eat the best diet you can afford, exercise if you can, and look after your mental health.
I would recommend separating the COVID booster on one day and flu the week after. I had a client, not even in our situation had an exhaustive dehabilitating reaction (6of10). While I’m not a doctor, and they say it’s okay to do both at once, why would we with immune compromised systems?
I did what seemed to be great on abatacept injections for just about 2 months. Not any extraordinary side effects, until something strange happened. Obviously different for everyone, let me preface this with a hx of lung interstitial bronchiecstatis like symptoms since 2012 treated by pulmonologist. All my issues cleared end of 2017 and my RA (by blood) and Psoriatic arthritis went in remission. I contracted COVID March 2020 and it’s been a whirlwind since. Hard differing COVID longhauler symptoms from my arthritic flares. Nonetheless, I was on abatacept July and august. That last week I end up in the ER with what seems to be a a pulled muscle in neck and shoulder that led to excruciating pain with movement. Ruled out stroke, heart attack, and doc figured it was a muscle pull—-he comes back with CT results and says there is no muscle pull but I had something in my lung - mucous impaction about 22mm wide. Pretty large compared to history of What may be RA nodules being average 10mm in size. Released me with steroid shot, steroids and strong antibiotics. Next day I go to pulmonologist (no cough, no fever, no headache)—he says well you also have pneumonia. After two weeks of home treatment, the day after the last steroid my breathing relapsed. The doctors did not want to engage in a conversation about a drug induced abatacept, nor the literature review I found, woman was about my age, 37. I ended up in hospital for a week, never been hospitalized in myLife. Truthfully who is to know what caused my symptomless pneumonia and if wasn’t for “pulling my neck” who knows what would have happened. Turns out the hospitalization also unveiled what they believe was heart damage from COVID, again not a lot of research yet; doc’s reluctant to discuss but started me on heart treatment for inappropriate static tachycardia. I’ve always been skeptical of medication side effects and try to not pay too much mind, but these meds for RA are powerful and again, people only discover what is reported as a side effect to the FDA prescription complaint line. Nobody can support or prove anything one way or another for everything I stated above other than that research literature article I found on the medical servers. Hope it helps to be on the lookout.
Well I had my booster took Abatacept next day with no affect, feels like flare up no relief at moment , told rhuemy nurse she said this wouldn’t affect Abatacept, sorry I think we know our own body, this happened when I had second vaccine 👍
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An RA question re vaccines for my learned friends 😊
British Society for Immunology statement on COVID-19 vaccines for patients who are immunocompromised or immunosuppressed
Is it ok to have a flu jab close to a steroid one?
Lunch chat about vaccines
