I am having my booster/3rd vaccine on Friday morning.... - NRAS


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I am having my booster/3rd vaccine on Friday morning. I usually have my Methotrexate injection on Thursday night.

Robin0 profile image

Mixed views on whether to miss it or not. Any advice.

35 Replies

I'll be interested in the responses you get.I missed my injection for the first two vaccinations, partly because it was due the day after and I didn't fancy adding the Methotrexate fog to the slight fluey effects of the vaccine. This time (had my 3rd jab on Saturday) I missed the two previous Methotrexate doses and the one after but will probably inject next weekend. My RA is well-connected atm and I'm also on Hydroxychloroquine and Sulfasalazine so didn't feel that missing Methotrexate would affect my joints and I was right. Interestingly, the fluey/tired vaccine reaction seemed to be a bit stronger this time (but went after a couple of days) but that might be coincidental or my imagination! 😁

Robin0 profile image
Robin0 in reply to Boxerlady

Thank you Boxerlady

Hi Robin0. I inject MTX on a Saturday (my booster was booked for a Saturday too) and on the advice of my Rheumy nurse, I skipped the MTX injection.

Robin0 profile image
Robin0 in reply to springcross

Thank you

I was told by my rheumatologist that MTX has such a long half life that missing a few doses would have little effect. He was also concerned it could put me in a flare, and then my body would be too busy fighting that, that it wouldn’t make as many antibodies. I’m on biologic, MTX, prednisolone, hydrocortisone, Montelukast and 2 steroid inhalers. I’ve just had an antibody test 4 weeks after the 3rd dose. I was found to have a strong response consistent with being fully vaccinated. I didn’t stop any of my medications, which is what my 2 teams advised

Robin0 profile image
Robin0 in reply to Maureengibson

Thank you Maureengibson

Hi I'm on max dose of MTX and didn't skip it for any of the 3 vaccines nor the flu jab.

Robin0 profile image
Robin0 in reply to Dobcross1

Thank you Dobcross1

jarujuda profile image
jarujuda in reply to Dobcross1

Same. I didn’t even think of stopping my methotrexate 🤔

springcross profile image
springcross in reply to jarujuda

I didn't for my first two jarujuda, was told it wasn't necessary by the Rheumy nurse.

Hi there, I had my phenmonia jab in one arm and flu in the other at 5pm on fri,and I still took my dose of methoject on the same evening and was absolutely fine 🙂 my rheumy told me not to miss any meds. I am also on sulfasalazine . And same when I had my covid booster.

Robin0 profile image
Robin0 in reply to jojoishere

Thank you jojoishere

I have my third primary dose on Monday which is my methotrexate day so I'm not going to take the methotrexate that day.

Robin0 profile image
Robin0 in reply to Pinkypie2018

Thank you Pinkypie2018. I plan to miss mine this week as RA is reasonably well controlled at present

There are the two options - 1.to skip it for a couple of weeks which might possibly help you make a better immune response and might risk a flare

2. to continue.

Which you are advised to do seems to depend on how likely you are to flare if you miss a couple of doses. And also on the preferences of the rheumatologist.

Robin0 profile image
Robin0 in reply to oldtimer

Thank you oldtimer- I think I will miss this week as my RA is reasonably well controlled at present.

I missed two doses of 20 ,mg methotrexate after third primary dose. Antibody test improved to >2,500. Maybe would have anyway? It was my decision, medics said not to. Seem to have got away without a flare.

Robin0 profile image
Robin0 in reply to GinnyE

Thank you- I plan to miss mine this week before my vaccine

Hi I’m due my to have my Covid booster on Friday. For the first Covid vaccination I stayed on my MTX the week I had it and came off for a week after it and was told by my Rheumatology Nurse that I had probably compromised the efficacy of the protection the vaccine could give me. I know there is debate around whether the body can mount an adequate immune response to the vaccine if the immune system is suppressed by MTX. For the second dose I came off MTX for a week before and a couple of weeks after. I didn’t have an RA flare. I subsequently caught Covid four months later at the end of September and I would say I am just back to my normal self after about 6 weeks. However I am now in a very painful flare up as I had to stop MTX when I tested positive for Covid. I will not restart my MTX and begin Prednisolone to get things under control until two weeks after my booster shot on the nurses advice. It’s not ideal but I don’t want to find myself with Covid again if possible.

I left out my metho tabs and felt better for it. I also left it out when I had the flu jab.

Robin0 profile image
Robin0 in reply to madme1

Thank you

I missed one dose either side of my 3 jabs but this is not medical advice. I have had conflicting advice from medics so made my own decision.

CagneysMum profile image
CagneysMum in reply to Sheila_G

I did this on my 3rd jab too. Completely my own decision, not on advice from anyone.

I missed my mtx before and after.

Robin0 profile image
Robin0 in reply to ABwn

Thank you- I will definitely miss before but not sure about after

I was unsure what to do. I usually inject MTX Thursday evening but was having my 3rd jab Friday so in the end skipped that dose and will inject as usual tomorrow night. I have found if I have my blood test the day after injecting my white cells and neutrophils are really low but they recover during the course of the week so thought may be it would help to skip the MTX for a week. 🤷‍♀️

Robin0 profile image
Robin0 in reply to Gilliancheche

Thank you- that’s helpful

Morning… I take Mx on a Thurs usually but was ill with a cold and was being sick a couple of weeks ago so took my Mx dose a day later instead (Fri). My 3rd Covid jab is on Tues next week so I have kept Friday for now as my Mx day. This way I have half a week each side of the jab. I do not want to stop taking Mx as I won’t be able to move & will really hurt, which would lead to a flare etc etc.. This is the best decision for me. Xx

Robin0 profile image
Robin0 in reply to CripLady

Thank you - it’s hard to know what’s for the best but I am going to miss my injection on Thursday and vaccine on Friday.

I’ve had mine +flu jab too I got my injections on aWednesday night and had my Methotrxate the next day without any problems 😄

Robin0 profile image
Robin0 in reply to Mumcon

Thank you - that’s good to know

Sheila_G profile image
Sheila_G in reply to Mumcon

Hi. I had no concerns about side effects but wanted to give the vaccine a good chance of giving me some immunity without the mxt. I think we are all living with uncertainty and in the end you have to decide what you think is best for this situation as there aren't any experts to help as it is so new. Glad you were ok after your jabs. I was ill after first 2 AZ but no problems after 3rd Pfizer. Horses for courses I think.

Hi I had my third jab last Thursday, 2 weeks prior the gp told me not to have my mtx as I was so ill with a cold & chest infection, he also advised not having the covid jab for around 2 weeks, he said my immune system was already low so my body needed to fight this first.

I was rebooked for the jab for last week & the gp said its fine & to restart the mtx this week, I don't believe my PsA is fully under control & can feel my joints getting worse again so glad I'm restarting this week.

I was told to continue my biologic injection. I had it on the same day as my third vaccine. My injection is Etanercept Benepali.

Hi, I take methotrexate and haven't had any advice on vaccines from my rheumatologist. I'm having my flu and Covid booster this week but haven't skipped any doses of methotrexate as the advice in enclosed leaflet and also on versus arthritis/NHS is not to have live vaccines whilst on methotrexate. Both flu Jag and Covid booster aren't live vaccines. So on that basis I think I am fine to go ahead. However others may have further complications or additional factors to take into account.

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