Should I increase my Prednisone dose prior to receiving booster Covid vaccine.

[Purplecrow]

When I received my second Pfizer vaccine dose, I developed a PMR flare , from which it took weeks to recover. It's time for my booster (and annual flu vaccine), and I'm feeling anxious about possibility of another flare from the booster. Does anyone have any suggestions regarding avoiding another flare? I have found my PMR very "tame" since the flare remitted, and I've wondered if I have finally reached the end of this journey. I feel understandably anxious about "poking the sleeping bear", but I believe the booster (and my annual flu vaccine) are both necessary. Any thoughts from you Wise Ones will be most appreciated. My current prednisone dose is 4 mg, and I have no PMR symptoms, so am looking forward to next reduction in dose. By the way, I've been on this journey since September, 2013, so I am more than ready to give up my dancing slippers.

Thanks for your remarks, advice, in advance, Jerri

[DorsetLady PMRGCAuk volunteer]

Personally no, I wouldn’t increase ‘just in case’…last time might have just be co-incidence..one can never be 100% sure.

I would take paracetamol for the 24hours before vaccine and may 24/48/72 hours afterwards ….

but you know your signs of a flare, so be ready to act if it becomes necessary.

[Seacat30]

If steroids can reduce the effectiveness of the vaccine increasing the dose does not seem to be a particularly good plan?

[PMRpro Ambassador]

The trouble with increasing pred in the couple of weeks post jab is that it may well reduce the efficiency of the immune response. I had no flare on PMR symptoms after the first jab, I did after the second and the fatigue lasted several weeks but there were other factors that could have been influencing that. I don't think I would take paracetamol BEFORE the jab but I't certainly consider taking some after and I would do my best to avoid increasing the pred. I managed to leave it at the same sort of dose at the time, just abandoned the taper I was attempting. The immune response takes maybe 2 to 3 weeks to reach its peak so personally I'd risk the flare as being far less problem than getting Covid. Obviously anything that paracetamol doesn't sort needs to be considered as a flare - and maybe pred makes sense then but I wouldn't do a "just in case" increase in dose.

[Purplecrow in reply to PMRpro]

Think you're probably correct.... I'll give it a go, and see what happens. I still feel that my PMR has gone near remission since the 2nd dose, after the flare. let ya'all know in a few weeks.

[pegpowell]

I just had my booster Moderna dose with a sore, swollen upper arm for three days. I had a sore arm for the previous two but nothing else. I was on 3 1/2 mgs previously for almost a year but had to up it to 4 mgs recently because of PAD and a hip still needing replacement. I have been on pred since 2016.

[pegpowell in reply to pegpowell]

I would add that I did have a PMR flare on my hips because of the ailments described above before my booster shot. To avoid stress, take your flu shot several weeks after the Covid booster.

[Purplecrow in reply to pegpowell]

Thanks Peg, i think that is the best timing for the two vaccines. Flu seems less of a risk(?), but who knows... its a bit of a crap shot. But we do our best