stop prednisone with flu vaccine?

[bluegirl7]

I was told not to take my prednisone and antiviral to receive flu vaccine. Has anyone heard of that? That it would be less potent. When do we recommence ?

Thank you!

[piglette]

Who told you that? What are you taking the anti viral for? Non-live vaccines, like the injected flu vaccine or the Shingrix shingles vaccine, are safe to have while you're taking steroids.

[bluegirl7 in reply to piglette]

Hi. Someone at the pharmacy where I took the shot. One of the pharmacists. So I didn’t take my Pred and my valacyclovir today. He said I could resume tomorrow probably. Also no ibuprophen for sore arm and wait also until tomorrow for acetamenophen. Which I never have done before. Always take Tylenol for sore arm and slight fever

Just wondered if anyone else heard any of this of late.

Thank you

[piglette in reply to bluegirl7]

I think they may have been thinking of ‘live’ vaccines. The injectable flu vaccine is not live.

[Bcol]

That is not something I've come across, never been told to stop any of my medication for a flu or Covid jab and never had any problems.

[123-go]

Took my pred and Leflunomide as usual. Was told to take paracetamol if arm was sore but not needed.

[Kendrew]

Hi bluegirl7,

I obviously don't know your full health circumstances, and others with more knowledge will be along to advise further, but that definitely doesn't sound like you've been offered accurate or well- informed advice!

I have never been told to suspend taking my pred for any vaccination and never heard of this being suggested before.

I am aware that we are not to have any live vaccine whilst on steroids though, but the flu & covid aren't live vaccines and there's an alternative shingles vaccine that isn't live also.

Under normal circumstances, stopping pred suddenly is never advised as the consequences can be serious.

Being on pred suppresses the immune system....that's its job....so anything like the flu or covid vaccine will be less potent anyway. I would imagine that stopping it for one day is unlikely to make a lot of difference to that.

As I said earlier though...others with more knowledge will be along to advise you further.

[SnazzyD]

Who told you this? Stopping for the day will likely make no difference to effectiveness because the vaccine effects continue on for some time after. It is accepted that steroids reduce efficacy but that is also dose related. Under 10mg is much less likely to be an issue compared to 15-20mg upwards. The vaccines are not live so there isn’t that concern too. They should also know you can’t just stop steroids because of the risk of adrenal crisis.

Are you on antivirals permanently?

[PMRpro Ambassador]

I would say that is rubbish! The immune response to the vaccine is over a period of about 2 weeks - to improve that you'd have to stop the pred for that long. And THAT would downright dangerous for us in adrenal terms and guaranteed to trigger a flare, especially with higher doses in GCA.

They may have read this paper from during the Covid vaccine programme

ncbi.nlm.nih.gov/pmc/articl...

but they also comment that it was not yet known how it would affect the novel mRNA vaccines. SInce then, it has been found that a 3rd Covid jab brings the response up to the same as without immunosuppressants.

In contrast, this

pulsetoday.co.uk/covid-19-p...

encourage adminstering vaccines WITHOUT changing the pred regime. The only case where action can be taken is if you are waiting for an elective steroid injection or to start pred treatment and then it is advised to have the vaccine and wait 2-3 weeks before the injection or starting the treatment. A relatively old study (1998) found that oral pred did not reduce the immune response in children on pred for asthma.

Pred does suppress the response to some extent but it is felt to be negligible at low doses of pred - usually defined as under 20mg/day.

And the CDC specifially says:

"Antiviral drugs used for treatment or prophylaxis of influenza virus infections have no effect on the response to inactivated influenza vaccine (2)"

cdc.gov/vaccines/hcp/acip-r...

[bluegirl7]

Thank you everyone for your responses It is a confusing topic. Especially for me. Couldn’t recall what I did before but I don’t think I stopped meds for the day. My husband has been very sick for 2 years because he had a reaction to the Moderna booster Did fine with vaccines The first Moderna booster was full strength and then reduced to half. They publicly never explained why. The only thing that saved him was massive iv doses of prednisone That controlled the antibodies he was making that attacked him. He had 55,000!!! So I got confused about ability of Pred to hamper response. Anyway I will go back on today because I am in a bit if a flare. He has now been diagnosed withOcular Myasthenia Gravis. There is some thought that since this is an autoimmune disease it could be related to the autoimmune type response he had to the booster.

Anyway thank you all for being so kind and so smart all the time!