Timing of flu vaccine when on weekly Tocilizumab

[Frenchduck]

Hello all

After an unsuccessful trial of 5 months without Tocilizumab, I am back on weekly injections. It's also time to have my flu jab. In the past when on two-weekly and three-weekly injections it was easy to fit the flu vaccine in not too close to the injections.

Now, the best I could do would be a 3 or 4 day gap. I'm not sure what is best or whether I should have the flu jab at all? It's too early in the reintroduction of the treatment to miss one of the Tocilizumab injections.

Is there anyone else in the same situation as me? Advice much appreciated.

[PMRpro Ambassador]

It isn't thought to make much difference with most biologics because of the way they work - they have a very specific target rather than just suppressing all immune function so don't interfere with the immune response to the jab. Rituximab is the only one that isn't like that. And anyway, the immune response isn't immediate, it takes up to a couple of weeks to develop. I get the jabs when they are offered irrespective of the relation to the TCZ, no-one has ever said anything different.

[Frenchduck in reply to PMRpro]

Thank you. I was hoping that was the case.

[Mgpa]

I was diagnosed with Gca six months ago and have only been on TCZ for four months therefore I’m not in a position to advise on it’s use but was told that it is perfectly safe to have flu and Covid jabs

[Frenchduck in reply to Mgpa]

Thanks for you response. It seems to be the case that it's okay.

[Greytree]

i am on monthly TCZ/Actemra and my rheumy said to take my flu and other shots in between those infusions. I took a flu shot two weeks in after last infusion (got a monster headache but I have had a sinus infection.) Will do same when I take covid jab. I refuse to take the shots at the same time,

[Frenchduck in reply to Greytree]

Thank you Greytree, that's useful to know. This time last year I was taking TCZ every 3 weeks so it was easy to leave a gap between injections and the flu vaccine and covid vaccine. Like you, I wouldn't take them together. However, since trying to stop medication (TCZ) altogether in April, the inflammation came back and built up. A PET scan showed that the GCA was still active. So five months down the line I had to go back to weekly injections. That was September.

Can I ask you how long you have been taking TCZ altogether and how long you have been on monthly injections? Is there a plan for you to come off them altogether and how will your rheumy decide when it might be appropriate? I'm really interested in how this question is tackled by other health professionals.