RSV injection and Methotrexate

[Golf-1]

Is it the same advice as for Covid booster please?

Stop the MTX just before and just after the RSV Jab?

[DorsetLady PMRGCAuk volunteer]

Think usual advice is to stop MTX for 2 weeks after any vaccine.

[PMRpro Ambassador]

Probably - the original study was done on response to flu vaccine so it almost certainly applies to all vaccines.

[Golf-1 in reply to PMRpro]

Thank you DL & PMRpro for your replies that confirmed what I suspected was the case.

However, before having the RSV jab I asked the GP if I should stop the MTX for a while, she did not know so looked up something on her PC and said "There is no suggestion you should stop steroids when having RSV jab" so I went home and took the MTX that I would normally have taken that morning.

BUT - thinking about that conversation a bit later in the day (last Wedesday) I thought rightly or wrongly ? that MTX is not a steroid ?? so I immediately took the Folic Acid I normally take 24 hours later, thinking this will nullify the MTX, and give the vaccine a chance to work.

I am also not going to take MTX this Wednesday.

Is my thinking all wrong, should I carry on as planned? or should I talk with GP about having the RSV jab a second time?

[PMRpro Ambassador in reply to Golf-1]

You shouldn't stop steroids no - that is very risky if you are long term steroid patient. But MTX is not a steroid, it is an immunosuppressant. I doubt the folic acid made much difference one way or the other but missing the next MTX will be a help since it takes about 10-14 days for the immune system to actually do the deed and respond to the vaccination. It is recommended to miss the 2 after the jab - you might have taken the MTX a day or two before the jab which isn't that different to what you have done.

I have mixed feelings about the RSV jab. If you have a lot of contact with very small people, cuddling them, being splothered all over and pawed by mucky hands they have licked or sneezed on to, then fair enough but RSV is only spread by direct contact with saliva and snot. It isn't a respiratory airborne spread like Covid or flu. Avoiding babies and toddlers and being very assiduous about handwashing is probably just as much use for YOUR protection.

[DorsetLady PMRGCAuk volunteer in reply to Golf-1]

Doubt they would consider repeating RSV vaccine... you probably have some [enough] protection..