Tapering and Covid shots

[Skier321]

Hello this my first post i started at 40 mg of prednisone in June for my pmr reduced down to 8 mg then relapsed went up to 15 and am now at 13.5 and will reduce slower now. My pmr may have been triggered by my first Covid shot. I was on 40 mg when I got my 2nd shot and 9 mg when I got my 3rd shot I wonder how effective if any my second and third shots are given I was taking prednisone at the time. Any thought on this my doctors isn’t sure how protected I am.

[PMRpro Ambassador]

Our general attitude is to hope for the best but assume the worst! I haven't really changed my behaviour at all despite 3 shots and I was on 15mg pretty much all the way through. I still avoid crowds and wear an FFP2 mask - but it is required by law almost everywhere here.

At 40mg it is fairly unlikely your immune system reacted well to the second jab but the third one should have done something but no-one can known.

40mg was a very high dose for PMR - 25mg is the recommended starting dose and 40mg the basic dose for GCA. Was there any indication of GCA at the time? We do have several people on the forum whose PMR appeared soon after a Covid jab - but it can happen with any shot, flu or shingles too, or any of the illnesses that the vaccinations are to prevent.

[Skier321 in reply to PMRpro]

They started me on 30 mg but increased to 40 mg because of pain and stiffness checked for GCA but no biopsy I am most concerned about tapering off this drug but I realize this is a long slow process

[Blearyeyed]

A general rule of thumb with professionals I have spoken to is that the vaccine will have definitely created Covid fighting antibodies to the same level in the body of people on any drug that can cause immunosuppression , including steroids and Methotrexate as it would for those in good health.

They did seem to agree , however, that the body itself , being more immunocompromised , could still be more at risk of catching Covid or developing it than you would be if you are a healthy person on the vaccine , but , the vaccine and antibodies that your body has managed to produce at any dose would help reduce the risks of hospitalisation or a very severe infection.

Their opinion was also that it was imperative to keep getting the boosters because the level of antibodies in the system of vulnerable people reduced at a quicker rate than it does in healthy individuals , and again , obviously , your body on certain drugs, or with certain illnesses, is more susceptible to catching a virus , so keeping those antibody levels up was really important to prevent the chances of a severe case or hospitalisation.

As your last booster was at a point when you had lowered your steroid dose below 10mg , the approximated dose of 10mg or higher is considered a point when the steroid dose can make you more immunosuppressed , and more at risk of catching any type of infection , not just Covid , at 9mg , therefore, you should be in a much better position as well.

Obviously , its still really important not just to rely on your vaccination but to still maintain taking all the sensible precautions like mask wearing , social distancing , good ventilation when indoors and hand washing. Especially as you have now increased your dose to 15mg , over that 10mg guideline.

[Sharitone]

I was on 50mg pred at the time of my second vaccine, and the dr who did it said as it was such a high dose, it probably wouldn't be very effective, and I should get a third one in the Autumn. So if she was right, then you should have some protection. On the other hand, I met a lady who has no disease at all, but took part in a trial that tested for post-vaccine antibodies, and she was found to have none at all!

[PMRpro Ambassador in reply to Sharitone]

Has to be added though that antibodies are not the whole story - t-cells are probably more important and they aren't tested for.