methotrexate and Covid booster

[Avon14]

I’ve just had my Covid booster, when I asked the nurse if I should pause my methotrexate for 2 weeks she said, no, definitely not. She checked with the GP there and they said there was no evidence to support pausing methotrexate. I’ve definitely read that pausing methotrexate is helpful. I’m currently on 6mg prednisolone and 15mg methotrexate weekly injections. Any suggestions please?

[PMRpro Ambassador]

Well the GP is WRONG!!!! Obviously don't read their copy of BMJ ...

ard.bmj.com/content/81/6/881

says

"Conclusion MTX reduces the immunogenicity of SARS-CoV-2 vaccination in an age-dependent manner. Our data further suggest that holding MTX for at least 10 days after vaccination significantly improves the antibody response in patients over 60 years of age."

Have you an opportunity to pass it on?

[PMRpro Ambassador in reply to PMRpro]

PS - that they don't know doesn't surprise me as the work is from Berlin 😉

[Avon14 in reply to PMRpro]

Thank you for clarifying. I had read several reports but just wanted the nurse/GP to confirm as I often doubt myself. I will email the surgery with attached link.

Thank again.

[Gaz227 in reply to PMRpro]

this is concerning I have my Co-vid booster on Wednesday and I haven’t been told anything by my GP or Rheumy to stop MTX at all . With it being a bank holiday this week the chances of getting a reply to my concerns are just about zero .

[Judywalks in reply to PMRpro]

thanks for that advice. I am having my COVID booster tomorrow . I have never been told I should not take Methotrexate after previous vaccines.

[PMRpro Ambassador in reply to Judywalks]

Some of the research is quite recent - it was originally done for the flu vaccine,

[Ann1A in reply to PMRpro]

Thanks so much, I have COPD and am in the at risk group, want to avoid anything that might make reduce immunity

[piglette]

I was actually asked if I were on Methotrexate when I had my vaccine as they said they would not give it if I were. I needed to stop it for around a couple of weeks before the vaccine.

[PMRpro Ambassador in reply to piglette]

Wrong there too - makes no difference stopping it BEFORE the jab, you can have it the day before bit it is the 10-14 days after that matter.

[piglette in reply to PMRpro]

They did say I should stop it after too! As I did not take it, I suppose I was not worried. I noticed it was mentioned on a handout fir one of my vaccinations.

[PMRrunner]

I've always been told that if possible to not take my methotrexate for 2 weeks after a covid vaccination

[Avon14 in reply to PMRrunner]

It’s very worrying that the information provided varies.

[dancersize2]

I agree about confusion. I did stop the due weekly dose before and after my booster last July then needed pred to settle the pains. Not sure whether to have the fifth booster and will certainly wait a month after my flu vaccination.

[Bluesew]

Very worrying about the confusion. I have never been advised to stop taking methotrexate after a booster covid jab. I will try to find out what my rheumatologist advises. Not keen to have yet another booster but GP says I should.

[KASHMIRI1]

My rheumatologist said to stop for two weeks after the vaccine.

[Linda20]

I'm in Tasmania. My Rheumatologist is a world renowned rheumatology researcher, and is also a virologist. His advice to me was to stop taking methotrexate for 2 weeks after COVID vaccination. He said methotrexate would prevent uptake of the vaccine by at least 50%.

[Phoebess]

Sorry to jump on the bandwagon....I have my spring booster booked for two weeks time.Im on Mycophenolate and prednisolone......does the same apply for that?

[PMRpro Ambassador in reply to Phoebess]

You can't stop the pred of course but studies show that mycophenolate does suppress the response to the Covid vaccine and stopping it for 10 days doubles the response.

rheumatology.org/press-rele...

Probably worth discussing with your doctor beforehand - or the doctor at the vaccination - and quote the reference.

[Golf-1]

I have my Covid booster booked for this Thursday at my GP Surgery, I mentioned that I was taking Methotrexate and asked if there was any recommendation about having both at same time. They suggested I check with Rheumatologist who prescribed MTX, the answer I was given was not to take MTX for at least seven days after Covid Booster.

As I take MTX on Wednesdays, that means I will miss MTX next week and resume following week so 2 weeks between doses.

[Mconway]

I was also told by GP and Rheumatologist not to stop MTX.

Very worrying.

[PMRpro Ambassador in reply to Mconway]

What stage was that at? Some of this work is relatively recent. And too many of them just don't keep up to date.

[Mconway in reply to PMRpro]

Last vaccine was end October 22. Number 6 vaccine due now. I’ve asked each time, different drs at health centre and hospital, all said the same.

[PMRCanada]

I was told to get my COVID booster before starting Methotrexate as it hinders the antibody response.