Prednisolone immuno-suppressant effect v Covid booster protection

Hello @macferse, Welcome to Connect. I've had two occurrences of PMR with a six year stent of remission between the two episodes. I've been in remission from the last episode for almost 4 years now. I've also had both Pfizer vaccines and the booster without anything other than the normal side effects and some fatigue. I'm really not sure there is enough data for anyone to answer your question but that's just my non medical opinion. I also just recovered a couple of weeks ago from what I think was a very mild case of COVID which I think may have been due to my having had both vaccines and the booster. I haven't had the second booster shot yet and will probably not get it now that I've had COVID.

Hoping others may also have some experience or information to share with you. Did your rheumatologist or doctor have any thoughts on your question?

Thanks for prompt reply, John. No, Rheumatologist was of the opinion that no serious studies had asked the question about the level and speed of undermining the immune system by steroids, nor a relationship with the initial but declining additional protection offered by successive vaccines. I mentioned I had read that the adjuvant present in all vaccines might be suspected of triggering PMR, but consultant felt their would be evidence of that showing already with the enormous scale of the real life experiment we've been participating in.
Stay Safe.

My PMR started after I got the Pfizer vaccine. I feel that it was triggered by the vaccine and have not gotten any boosters. I asked my rheumatologist his opinion about any relationship between PMR and vaccines. Similar to your rheumatologist, he said the science just doesn't support any connection. His take is that there would have been a large increase in PMR incidence since so many elderly people got the vaccine. I have my doubts, wondering if anyone tracks this, plus I think there are undiagnosed cases and people who were destined to get the disease but the vaccine hastened the onset. I asked him also if he thought I was immune compromised. He said that since I was taking less than 10 mg of prednisone he did not think so. He did not think I needed to be more cautious than the average person about travel, etc.

I am going to jump in here. The clinical trial science does not support a relationship of some type between a vaccination and the onset of PMR. However, there are individual case studies in the NIH database that do support it. I personally had my PMR initially diagnosed following my second Shringrix vaccination. I also happen to have pre and post lab results that support clinically the argument that the vaccination was the triggering event. Currently there are no clinical studies listed at the NIH being conducted on PMR and thus most data and knowledge is based on individual experience and happenstance. Doctors don't like happenstance. They prescribe based on clinical double blind work and simply have to ignore a great deal of what the lay person supposes. Fortunately I have a couple of doctors who understand the limits of the clinical knowledge on PMR and are willing to be open minded and realistic given the lack of clinical data.

All this said, I recently spoke to an Infectious Disease doctor who says there is limited data on the 2nd booster and that the decision to get it should be based on your health risk levels as well as your life style risks you assume daily. Meaning what other health issues do you have and how much to do you expose yourself? I for one have no desire to die from Covid and will probably get my 2nd booster before the summer is out. I also have no desire to have a PRM setback so it is indeed a balancing act. Every vaccination I get since my Shringrix vaccination scares me. I feel like I deserve a "You are brave!" sticker every time I get another vaccination.

No doubt there is a relationship between Covid antibodies and your medication regiment. Common sense tells us that. However I doubt there are any clinical studies going on relative to Covid antibodies and steroids since the infectious disease doctor I spoke to indicated that there is little hard data on a great deal of Covid related issues. Quantifying what seems to be an obvious question is evasive. I have to keep remembering that PMR is a rare disease and the demographic is the geriatric population. There is precious little data on us for main stream medical problems. It can be discouraging, which is why this chat room is so helpful.

I too was diagnosed with PMR then eventually RA AFTER receiving the shingrix vaccines. I have also experienced relapse of symptoms after COVID vaccine and the booster. I also got COVID twice. Not sure if I’m up for the next booster yet.

Shingrix

I got PMR after a Reclast Infusion… my recent concern was after 7 months on Prednisone my two vaccine boosters would not be effective. Spoke with my doctor and we agreed upon my getting Evusheld — the monoclonal antibody pre exposure prophylaxis. In short, there is no real data because no one has seriously studied the PMR level of prednisone combined with the advanced age (and age has an effect on vaccine efficacy too) and success of vaccines in providing antibodies.

Right after I got my Flu vaccine I got PMR. It has been 4 1/2 yrs, and had to retire from work. I took the covid vaccine to go on a cruise and I was unable to walk within an hour of getting the first vaccine. Had to take a prednisone dosing starting with 3 days at 80mgs. It did improve but it will be a slow process back to normal. I got the 2nd covid vaccine 4 weeks later and PMR symptoms were increased in back and arms took 10mgs of Prednisone for 3 days then back down to 5mgs and I have not titrated down yet as the symptoms are still very present. I have just started taking PEMF (pulse electro magnetic field) treatments They have helped a great deal the first 3 consecutively!

After shot of shingrix next morning woke up with sciatica. Very painful. epidural 2 weeks later and it was gone. Just had shot of monoclonal antibodies. Fatigue next day. That’s it. On Actemra and prednisone. Had 0 antibodies from vaccine. Now protected for 6 months. Don’t know when it’s safe to go back on Actemra. Docs. Don’t know either. ESR and CRP very high. We need more help with autoimmune issues especially in Florida. Been to Mayo about 10 years ago when PMR started sorry that was GCA. Big trip. I’m now 80 with walker. Can’t do it again. Wish we had someone here. The Mayo in Jacksonville is just not the same.

Good luck finding any studies related to long term low level prednisone and vaccine efficacy. My guess is that rheumatologists are not curious and do not set up studies that are not related to routine inquiries about treatment of PMR.