Do I increase Pred to cover me for Covid jab?

[FleetRose]

I'm very anxious about having a Covid booster as I believe the vaccines precipitated my PMR early last year. I was advised (by consultant) not to have the 2002 autumn booster as I had some immunity from catching Covid itself but he has said to have the booster this year as it is now 15 months since my last one.

Would it be a good idea to increase my pred dose around the time of the jab to reduce the likelihood of a serious flare?

The Pfizer jab apparently does not contain adjuvants, unlike the Novavax (an adjuvant is added to boost a person's immune response). Last year I negotiated with my GP to have the under 65s flu jab (I am 74) which does not have the adjuvant. I did not think my immune system needed extra stimulation! However it was a battle and all pharmacies said that, by law, they could only give me the over 65's jab.

[PMRpro Ambassador]

Personally I wouldn't raise the pred dose, or at least not for more than a day or so, since it would also suppress the immune system response in creating immunity. IF you were to develop a flare then maybe it becomes a different matter. I have no idea what jabs I had, other than the first 2 were Moderna, the second 2 were Pfizer, I had a bit of a flare after the second Moderna one but it was more fatigue than aches and pains, but they don't have age labels here in Italy that I know of!

The vaccines may be the final straw in the preamble to developing PMR where they are the final trigger. Realistically, if it hadn't been the vaccine, it could have been the next poke at the immune system that did it, Covid itself, a fall, some other illness. Who knows.

[SnazzyD]

Any increase in Pred will reduce the effectiveness of the vaccine as it is immunosuppressive so it’s a toss up as to which you worry about most I guess. Also there’s a question of how long do you increase the dose for? A vaccine doesn’t just stop its effect after a few days. If it were me I’d keep the dose the same and only increase if the flare starts while expecting aches and pains in the first week of the jab which is common anyway. You may be fine.

[FleetRose in reply to SnazzyD]

Thank you SnazzyD and PMRpro for your helpful advice. I can see it makes complete sense not to reduce the effectiveness of the vaccine. I’m just terrified of going back to where I was at the outset.

[PMRpro Ambassador in reply to FleetRose]

I do understand that but it is unlikely since you have pred in your hand and can act quickly if it should happen. I certainly didn't end up back where I started and it lasted only a few weeks. Other things had a lot more effct in causing flares.

[papadapadoo]

I had the Pfizer COVID vaccine and also flu shot yesterday. No issues with either.

[Gardenbay]

I have recently had my Covid and flu jab the same day, no problems at all.

[discoballs]

I had my COVID jab on Sunday. I felt a bit knackered for a few days but OK now. No flare up. David

[Sweetpeasoprano]

I also think that my first COVID vaccination precipitated, but didn’t cause, my PMR. I have had all the COVID vaccinations that I’ve been offered and suffered no ill effects from those. Having said that, for the first time I had COVID and flu vaccinations together two days ago and did feel a bit off the next day. My arm felt as though someone had punched it hard but It never occurred to me to increase my pred dose! A couple of paracetamol did the trick.

Two years after being diagnosed with PMR and starting on 15mg/day I’m down to 0.5mg. I followed all the advice on this site and decreased v e r y s l o w l y - much more slowly than my GP’s original advice. It seems to have worked so far…

[FleetRose]

Thank you for all your replies and encouragement. I should have added that I have a particular concern at the moment. In the last couple of weeks I have had some vague head symptoms. Nothing drastic or acute but a persistent very slight head-ache, eye ache, nasal congestion and ear and tooth discomfort. Of course it could be sinus/tooth problems or anxiety! I asked the GP for a blood test (I have no monitoring unless I ask for it) which I had last Thursday, but he has only requested CRP. The earliest I could get a appointment is next Thursday so for the moment I have postponed my Covid jab until I at least can check the CRP isn't raised when I check the results on Monday.

[Exflex]

Personally I wouldn’t take extra Pred preemptively.