Hi can anyone help my confused brain regarding this 4th covid vaccine
I was under the impression that it you have RA and are on meds that lower your immune system you are eligible for having it, however when I phoned my GP she said you must be on 20mg or more methotrexate to be eligible.I am on 12.5 methotrexate injections along with hydroxy.I’m assuming this is correct but as my consultant has just retired( waiting for referral to another one) I can’t ask her.any thoughts anyone🤦♀️Thanks
That is what my GP and head pharmacist at my local trust said too. I am on 15mgs of MTX but that does not count apparently. It is only the biologic that I take that qualifies me for it.
Thanks Wobbies seems a bit daft as we are all immunosuppressed but obviously down to the strength of the meds
Yes your GP is right…if you look on a post from Maureen Gibson I think it was ….she posted a list of eligibility a couple of days ago.
I'm eligible because I'm on 20mg Metoject; the hospital pharmacy which supplies it sent me a text. The good thing is that you know that you're not particularly immunocompromised. 😉
Yes your GP is right. See box 1 on page 25 for the criteria for a third primary vaccination (i.e. 4 in total) assets.publishing.service.g...
However, it is worth noting that it relates to the medication you were on at the time of your first and second doses not your current medication.
The hydroxchloroquine doesn’t apply. Whilst it's an immunomodulatory med it doesn't suppress your immune system enough. With methotrexate it's 20mg or above. That said I’ve had 3 primary & a booster & I’m on 17.5mg injections. I am on maintenance dose prednisolone however, though I'm not clear if it's length of time or dose which has made the difference. My GP Surgery has arranged all my appointments. That said I received a letter through the post on Monday inviting me for my 4th (booster) dose, a tad late as I had it on 20th December! It would seem your GP is correct I'm afraid.
Do you have access to a Rheumy nurse? If so you could act dumb & see whether she/he thinks you should have it.
As you’re describing it as maintenance dose, it’ll be the length of the pred, I suspect; relevant dosages as per the BRS are 20mg or greater a day (or 0.5mg per kg) for 4 weeks OR any dose for more than 4 weeks alongside any immunosuppressant DMARD or biologic.
Thanks for explaining Charlie, that answers it perfectly. It will be the latter, as it's 9 years for both pred & MTX together, although I’ve been on MTX longer.
The criteria for a third primary dose for those taking steroids is as follows (copied form the Green Book Chapter 14a)
long term moderate dose corticosteroids (equivalent to ≥10mg prednisolone per day for more than 4 weeks) in the 3 months before vaccination and those on ≥7.5mg prednisolone per day in combination with other immunosuppressants (other than hydroxychloroquine or sulfasalazine)
Thank you for explaining, helpful to know.
Hi I’ve had my fourth jab and I’m on 15 mg of methotrexate and 2 and half mg of prednisone hope you get sorted
Hi Gladjake, if I were you I would contact your Rheumatology department and ask their advice on this matter. I was sent a letter from my rheumatologist telling me that I should have a 4th jab. I went to the vac centre with the letter showed it to the nurse on checking in(as instructed by my rheumatology dept) and I was given the 4th jab. My meds by the way are Etanacept injection once per week, sulphasalazine and 5mg of prednisolone.
Hoe this helps.
Ray
I was told as I'm on a biologic (rituxamab) I am supposed to get 4th.
You need to speak to your rheumy nurse……she will tell you how long after your last infusion you need to wait before you go for your fourth jab!
Yes, I have. Am having mine on Wednesday in time to have my next infusion when it is needed. So far I've done 7 months as it was my first time having it in July and at the moment I'm OK. So now is probably the best time to have the 4th one. Thanks.
Hello Gladjake - I've just read Wobbies reply to your question, and that is how it is for me. I have 10mgs of MTX plus a biologic, and it's the biologic that makes me more vulnerable to covid - hence the 4th vaccine. And I had the 4th just yesterday.
Hello - that us I understand it too there was, I think somereference to this on the NRAS website. It is so confusing.
Hello, My GP gave me my 4th Covid shot a week ago. I am on 10 mg of Hydrocortisone which equals 2.5 mags of Prednisone. I have RA along with PMR. I also receive 800 mg of Actemra via infusion every 4 weeks.
How confusing it all is.
I was on MTX which, following nausea was then replaced by mycophenolate. This, I took for several years but they never did get a diagnosis straight even though it was agreed I had an auto-immune condition.
The rheumatologist, however, suggested last summer that I should not be taking such powerful drugs and so she told me to taper the dose to zero last August. There was no replacement and yet, I received a letter from her last week saying it was important I have a 4th dose
Hello, Gladjake. The rules have changed (yet again!), and now, if you are on Methotrexate at all, you qualify for a 4th jab. I volunteer at our local GP Vax centre, & was shown the table for qualifying yesterday. I had previously asked for a 4th, & been refused, but the RA Nurse at the hospital has told me I qualify, & has written to my GP. I have to just show proof of Mtx treatment. Fingers crossed, I will have mine at the next clinic on Thursday. Good luck with yours!
Yes, all done very easily. So glad I contacted the RA Nurse - I would definitely still be waiting & wondering otherwise......Good luck with yours.
Pleurisy & covid jab 
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