Methotrexate/jabbed/worried: As well as having PsA I... - NRAS


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fangrock profile image
8 Replies

As well as having PsA I suffer from anxiety and just read this on the guardian:

I've had two jabs, have kids at school, go to the office one day a week. I feel a bit hopeless.

I had both jabs before starting MTX

What I don't know is, how compromised is an immune system with 20mg of MXT a week? Severely? Totally? Just a bit?

I like to think that it just lowers levels of immunity down to somewhere around normal, but I don't know.

Has anyone got any soothing thoughts?

8 Replies
oldtimer profile image

Methotrexate will probably reduce your raised level of immunity to around normal. It's the raised levels of immune substances which do the damage in Rheumatoid Arthritis .

It is sometimes suggested (depending on the rheumatologist's opinion of the balance of risks) that you should stop methotrexate for two weeks before and after having a vaccine as one study showed that doing that increased the immune response, but you are still likely to have a reasonable response to the vaccine if you haven't done this.

The person in this article was on Rituximab which supresses the immune system probably more than most biological treatments and I was surprised to read that she, and her family, were unaware that this was likely to reduce her immunity. She should have been advised that she was likely to continue to be at risk. It's a pity that the journalist did not ask NRAS who would have given a more balanced picture - but, of course, sensation and alarm is what sells newspapers.

Boxerlady profile image

I haven't read the article but when they were talking about who should have a third primary jab (as opposed to the booster) they only included those on Methotrexate who were on more than 20 mg so that shows that we're not considered to be severely immunocompromised; it's different for folk on certain biologics. I'm on 20mg of Methotrexate (by injection) as well as two other DMARDS and am taking sensible precautions (mask wearing when in shops, not spending long periods inside with lots of people) but am working f2f, going to Aqua classes etc. My RA is well controlled atm due to my medication and I believe that gives me protection from serious problems if I did contract Covid - hope this reassures you a little. 😊

helixhelix profile image

A sad story…but she was on Rituximab and had diabetes, and from the photos looks as if she was overweight. Plus having been shielding for 18 months may not have had much exercise. So a whole basket of risk factors for the poor woman as well as RA drugs.

Like Oldtimer I’m surprised she didn’t realise. Along with steroids, Rituximab is the most immune suppressing of our drugs. Other have far less of an impact, so please don’t assume the same will happen to you!

I am on Enbrel and MTX. My blood tests usually show a good profile of a functioning immune system with normal levels of white blood cells etc. Also when I get small scrapes and cuts they tend to heal quickly, and I (fingers crossed) haven’t had so much as a sniffle for years. So I have stopped worrying - life is for living as much as one can.

fangrock profile image
fangrock in reply to helixhelix

I love this. I have some hope! Thank you :-)

Deeb1764 profile image

Also call the NRAS hotline if it helps talking to someone if you cant get hold of your RA team. Sometimes talking it out helps too!

Neonkittie17 profile image

When you read further down towards the end it says her medication is Rituximab. This is known to blunt the efficacy of the covid vaccines if it’s not timed really well between periods of B cell depletion and it also can effect flu and pneumonia vaccines. Mtx has also been shown to affect vaccines (there are tests called functional antibodies to see if you’ve responded to those. I didn’t.) I think you always need to ask these questions to your rheumy team for the best possible outcomes re vaccine timings, but not been possible for all to do so given so many people couldn’t get to speak to their rheumys in the last year or so. Not everyone in Rtx or the other higher spec meds have researched or chased this up as they we’re relying on rheumys to do so and they haven’t been able to discuss with patients.

Some of the press are only just realising what Rtx is doing to people re blunting the vaccines. So are the patients. I would speak to your rheumy for your own peace of mind/your reassurance. 💗 If you look on the British Society of Rheumatology (the site rheumatologists use for their info) re. classifying who was CEV/vulnerable, Mtx as a solo med at your dose wasn’t a reason to shield or be classed as CEV. It doesn’t wipe out your B cells for example like Rtx does, but it does slow your immunity down as that’s its job as such.

GinnyE profile image

I’m on 20 mg methotrexate, nothing else. The British Rheumatology Society recommended that anyone taking methotrexate should have a third primary vaccine. I had two antibody tests that showed I’d made antibodies but that the level had dropped so I got a letter from my Rheumatologist to take to a walk in centre and got the third primary vaccine. The good news is my antibody levels increased enormously. I’m going to chase up my booster soon, which they told me to do. I post this to reassure you and that you can increase your antibodies by a third primary if you want to.

Poshcards profile image

Heartbreaking xx

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