Pred and vaccines (sorry, yes another damn post on this!)

[Exflex]

Some may remember I was on Pred for 4 years with PMR on the slow reduction shift. Well I’m back on prednisolone this time due to lung inflammation due to Covid and Pneumonia. Starting dose was 40mg/day for 7 days, today I’m down to 30mg for the following 7 days, then reducing week on week by 5mg to come off, target for being off Pred sometime in November.

As the Covid and Flu vaccine invites are going out now I’m wondering how long I should wait for the dose of Pred to fall to a level where my immune system can actually use the Covid and Flu vaccines efficiently. Any ideas / views? (I’ve read less than 10mg.)

PS both the respiratory and rheumatology consultants I saw in hospital said the ‘sweet spot’ for getting off steroids and adrenal recovery is 3 months. I’m about to find out in November, sometime. My GP just looked at me without comment when I mentioned this.

[PMRpro Ambassador]

In the case of the Covid jab, I think it was decided that although the immune response to the first 2 jabs was damped by pred, by the time you had had 3 you were catching up. So the Covid jab should still have an effect. And since I'd want them on separate days, you could have the flu jab 2 weeks later?

[Tribie in reply to PMRpro]

Sorry just curious - is it better to have the two jabs on separate days? I’ve booked to have mine together but will change that if you think it best. I’ve never had a reaction to any vaccination apart from mildly sore arm so just thought I’d get it done in one hit!

[DorsetLady PMRGCAuk volunteer in reply to Tribie]

Personal opinion yes -if you have both at same time -

a. It’s a double assault on the system to cope with, and

b. If you have any issues you don’t know which one has caused the problem.

[Tribie in reply to DorsetLady]

Very sensible, didn’t think of it this way, thank you.

[PMRpro Ambassador in reply to Tribie]

My GP feels at least a week apart is preferable. So do other doctors and I agree. It isn't the injection site reaction that matters for us but how the immune system responds and since our immune systems aren't in a perfect state, I think it is preferable not to overstimulate it by throwing two lots of vaccine at it. Not to mention if they contain adjuvants to increase the immune response - I'm sure 2 lots of that at once can't be good for us.

[Tribie in reply to PMRpro]

ok thanks for this - I’ve just cancelled my double appointment and will book them separately. So glad I saw the post!