PMR and Flu Vaccine

Flu vaccine as a trigger? The way it was explained to me was that PMR comes from underlying predisposition + trigger. This was from a doctor who specialised in diagnosing illness. Neither of those elements that cause PMR is very well-understood. But in my case the advice was basically - Northern European genes (one half of the family Scottish - probably a fair amount of Norwegian genes) plus a history of sinus infections then age and possibly over-use of already strained muscles, then the dramatic trigger which was the flu vaccine. The flu vaccine does appear in the PMR research and has been known as a potential trigger for some time. It is largely thought to be due to the adjutants used in a particular batches, so not all flu vaccines may act as a trigger. I haven't had a flu vaccine since 2023 when PMR hit, so I don't know if the vaccine still acts as a trigger for a flare once you have PMR. Certainly lots of things can flare this illness. I have recently been fighting a 6 month recurring flare that made tapering impossible. It was finally linked to methotrexate toxicity, but not before I was severely ill. Now off the MXT and feeling a whole lot better, and getting the PMR under control and tapering again without major issues.

PS. I should mention that I had already replied to this thread, but the above adds a bit more detail.

same here, covid and flu vaxes = PMR for me so not taking a chance of recurrence now that I am in remission. Still struggling with semi-debilitating fatigue after a year of being off prednisone.

I’m being titrated off prednisone what causes this tiredness

I also got PMR several weeks after getting the flu vaccine. Years ago I had a rheumatological response to the tetanus vaccine. I haven't had a tetanus shot since and doubt I will ever get another flu vaccine. For sure cause and effect? No way to know, but there sure is a lot of circumstantial evidence out there.

I agree. I got both flu and Covid vaccine in October. The following Feb i started with PMR symptoms while on a trip out west. Have never had anything so weird and was miserable for the 3 weeks of traveling. I am not getting either vaccine this year.

I am relatively new to PMR. I think my symptoms started in Dec. 2024 but I wasn't diagnosed until Feb/March 2025. I have been on prednisone since and am now down to 5mg a day. I see my rheumatologist next month. Until recently I did not realize the link between vaccines and PMR. I had a flu vaccine about 6 weeks before onset of PMR symptoms and COVID about a week before. Many of you in this group are more experienced with PMR. What questions do you think I should ask my rheumatologist on my next visit? I hate to skip the vaccines because I have had lung cancer and I was recently diagnosed with t-cell large granular lymphocytic leukemia (T-cell LGLL) which puts me at greater risk for infections-I think. Apparently this rare slow moving leukemia is associated with rheumatic arthritic conditions. I am just learning about this disorder. Anyone have insight about it?

I’ll probably get the vaccines this fall tho I’ll have to stop methotrexate the day before shots then back on it the next week. I had the flu (1st ever) in spring & it was like a cold. I’d had the flu vaccine the previous fall. I think I’d rather NOT get the flu or covid by skipping vaccines.

I got both vaccines in the fall then bam- hit w/PMR in late Dec.
I think vaccines do trigger our immune system to ramp up. Not sure why as I’ve gotten both vaccines as soon as COVID hit us in this country (USA) & nothing ever happened. I never got the flu and I never got covid! No PMR.
BUT I did get the flu this spring but it felt like a cold only. So the vaccine worked but PMR drugs helped lessen my immunities.

There is no doubt that the Shringrix vaccine triggered my PMR. My adverse reaction started the day of my vaccination. I have had non-standard PMR symptoms and am working not only with a Rheumy but also an Infectious Disease doctor, a Cariologist and a Pulmonologist all a result of my 2nd Shringrix vaccination. I have worked with my Infectious Disease doctor on getting vaccinations. I got the RSV, Flu and Covid last Fall. I got each one 2 weeks apart. This year I will be getting the Flu and Covid 3 weeks apart. This Spring it was time for a tetanus booster. I got that and planned a one-week slow period to not push my body. I would much prefer to get the vaccinations than to have the problems, especially tetanus! Everyone' s journey is different and there is little medically known about PMR itself. Remember it is a default diagnosis, there is no test they have to run to confirm PMR. Advice is good, but don' t be afraid to ask questions and in the end you will need to make your own decisions since there is not a single standard of care for PMR patients. I wish you well on your PMR journey. I was sorry to hear of your lymphocytic leukemia. Even slow moving it is disturbing.

Thank you for sharing your experiences with vaccines (flu and covid.) I was diagnosed with PMR in June of 2023 and was able to taper off of Predisone with the help of Kevzara by June of 2024. Then was able to discontinue Kevzara by Feb 2025. Happy to report no signs of PMR over the last 8 mos.
I am reluctant to get any vaccines because of the possibility of a flair. Are there any studies you can point me to to support this theory?