Advice on MTX and Covid vaccine.

[Floralqueens]

I was advised to continue as normal with METOJECT and have the vaccine. Pleased to say that I’ve not been experienced any problems and I’ve had 3 Covid vaccines. I hope that this helps.

[Neonkittie17]

Do you mean no physical adverse reactions? It is always best though for each patient to check with their rheumatologist re pausing it for the Covid vaccines. Each person has a different health situation. Mtx was documented as affecting the efficacy of the flu and pneumonia vaccines and so they looked at if it could do the same for Covid vaccines.

[Runrig01 in reply to Neonkittie17]

I agree, my rheumatologist advised me to continue with my MTX, but that is because I quickly flare missing one dose. He said the danger then is that my body is too busy fighting the flare, it would be unable to produce sufficient antibodies. We are all individual I read a paper which quoted 40% of patients taking MTX mounted inadequate antibodies. I’m lucky I take 25mg MTX as well as a biologic, prednisolone, hydrocortisone, Montelukast, which all suppress the immune system. I also use 2 steroid inhalers. Yet each time I’ve tested my antibodies I’ve had a strong response consistent with having the full course of the vaccine. So I’m clearly in the 60% that do get a response, but there’s no way of knowing which group you fall into. So I agree each person should have a discussion with their specialist in what works. I also watched a webinar where one of the professors leading the Octave study advised his rheumatology patients to continue. It does clear your system in around 55hrs, although we take it weekly. if I miss 1 dose I get severe shin splints and toes too painful to walk on. I have my 4th dose soon and will check my antibodies again 6 weeks later. I realise I’m lucky I have a friend on 15mg MTX and the same biologic who gets a weak response. Stay safe everyone 🤗

[Neonkittie17 in reply to Runrig01]

Yes. lucky given your many meds. I’m not so fortunate. Rtx has done that. It’s the effects Mtx has on bone marrow suppression and T cell and IgG which are longer term issues affecting infections and immunity and for many Mtx does interfere with vaccines. Not just about the half life of Mtx. Yes, seen the Octave and the info so far. Would like to see more. Many medics are still not sure re Mtx and the Covid vaccines. There are so many differing views, especially from people’s own rheumys, but much more evidence now re Rtx and no antibodies. There will be people who were fortunate and got their Rtx timing right if they have a slower re-population of B cells. There will be others like myself who left 6 months as instructed between prior Rtx and first vaccine, but it wasn’t enough.

Very aware of how having uncontrolled RA can be dangerous at any time. My rheumy was quick to point that out back at diagnosis in 1995. I have had perfectly controlled RA on Rtx for 8 years, and not much time over the years when it’s been out of control. One or two weeks without Mtx has never effected me as Rtx has always been working so brilliantly. It’s how your rheumy sees the risk of pausing Mtx for you or not. I shall continue to wait and test for my B cells and then repeat my vaccines. Optimum timing.

Take care Maureen, and everyone as I have to take myself away from here for a while. I’m not being unsupportive I assure you ... anything but. I’ve been very supportive indeed for a long time whilst my med side effects and no vaccine response has been really awful to try rectify. I need to recharge. I’ll check back in to read useful info re the anti virals and all other wonderful NRAS advice and info and of course wish you all well for 2022. 💗