Flu or Flare or Neither?

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I noticed a report on a examine the opposite day that signifies stopping methotrexate (MTX) for 2 weeks after getting the flu vaccine makes the vaccine more practical – by as a lot as 15 to 20 p.c.

How the flu vaccine works

My first response was that this is sensible. The flu vaccine works by introducing the inactive (useless) flu virus strains into your system which then responds by constructing antibodies. Later, once you encounter the reside variations of the virus (typically from individuals round you), these antibodies make you extra proof against catching the flu.

Since methotrexate suppresses your immune system, your system is much less capable of make flu antibodies (which is one cause that catching the flu is so critical for RA sufferers). Stopping MTX after getting your flu shot due to this fact permits your physique a extra regular response to the vaccine and it makes extra of the antibodies.

Getting the flu appears just like having a flare

I’ve had the flu. The actual flu – not only a actually dangerous chilly. And I had it once I was a lot youthful and far more healthy. Now as an RA affected person, I actually don’t need to danger a good worse case of it, which is why I get my flu shot yearly.

The closest I’ve come to feeling as dangerous as I did with the flu is once I’ve had actually dangerous flares. The flares the place it hurts throughout. The place it hurts even to breath and also you don’t even need to take into consideration getting away from bed.

This brings me to my second response once I learn the headline about stopping MTX after getting the flu vaccine. Lacking two weeks of MTX is perhaps sufficient to place some individuals right into a flare. Apparently this wasn’t the case within the trial which included 199 sufferers. There have been no noticeable will increase in flares among the many RA sufferers. That being mentioned, primarily based on private expertise, I’m undecided I’d need to take that probability.

It’s unclear from what I’ve learn whether or not the sufferers have been on different medicines apart from MTX, equivalent to different DMARDs or biologics. In the event that they continued on with these remedies, that will add some safety in opposition to flaring.

Along with being offered on the nationwide American School of Rheumatology Convention, the examine was additionally printed within the Annals of Rheumatic Ailments.

A few issues:

First, you need to by no means change or discontinue any a part of your remedy plan with out discussing it first together with your physician. Hopefully that goes with out saying.

Second, you need to by no means get any vaccine with out additionally speaking together with your physician. Some vaccines like that for the flu and pneumonia are inert/useless vaccines. That’s, you’ll be able to’t get the illness from the vaccination. Nonetheless, different vaccines, like these for shingles, comprise reside virus strains (though they’ve been weakened). It’s potential, and generally advisable, for individuals with suppressed immune system to get these vaccinations, however solely underneath a physician’s steering as a result of there are dangers of truly creating the illness concerned.

After having the flu these a few years in the past, I all the time, all the time get my flu shot yearly. Whereas there’s no assure that it’ll maintain me from getting it, it’s positively one of the best probability I’ve of avoiding a really critical scenario.

Keep in mind that it takes from two to 4 weeks for the complete results of the vaccination to kick in, so that you may need to think about getting it prematurely of time the place you’ll have quite a lot of publicity – like vacation gatherings and journey.

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