Methotrexate & vaccines

My new Rhetorical had me get my first shingles vaccine before I started MTX. Strongly suggested I get the new Covid vaccine and flu in October/November. I’ve had 5 Covid vaccines with absolutely no negative effects. Three people I know are currently sick with Covid, and I volunteer weekly at a low barrier homeless shelter.
I have heart and lung problems, so yes, I’m going to be vaccinated but will space them out.

My primary suggested skipping COVID but getting flu shot.

Curious why did Dr say skip covid?? What’s the concern?

Think I will go ahead and do both the vaccines per rheumatologist advice. I’ll double check his advice when I contact him.
Thanks for your response.

The concern with vaccines is the immune stimulating affect of the adjuvant included in the vaccine to heighten an immune response to the vaccine to make it more effective. Since PMR is a condition caused by an excessive immune response, we have to be careful not to stimulate the immune system too much. Some adjuvants are worse than others and each of us responds to each adjuvant differently.

"Autoimmune/inflammatory syndrome induced by adjuvants"
"Adjuvants.... when added to vaccines they are meant to boost the effect and strongly stimulate the immune system. The response of the immune system can be unpredictable..."
https://academic.oup.com/cei/article/213/1/87/7071043
Each of us has to assess our own risks for catching anything being vaccinated for - it depends how exposed to others you are. I'm generally in favour of necessary vaccines, but haven't had any vaccinations since getting PMR over 2yrs ago. Instead, I avoid public places as much as possible and always wear a mask whenever it can't be avoided.

I think I'll get them both too. I think they offer some benefit to me, even though I'm taking Actemra and won't get a full immune response. I got a covid booster last year after I started getting treatment for GCA and PMR, and I was very surprised at the complete lack of side effects from the booster. In the past I had very strong reactions to those shots.

I was diagnosed with PMR in July 2023. Had Covid and Flu shots in fall of 2023 and 2024 with no side effects. I had 2024 shots done simultaneously and actually had less residual pain (soreness at shot site) than usual. Just had my physical a couple of weeks ago and had my DTAP and Pneumococcal Pneumonia vaccines with no side effects. He highly recommended the Flu and Covid shots, which I was planning on next month anyway.

Thanks for your info. I’m counting on my body being able to handle these shots! We shall see.
I’m waiting to hear from rheumatologist today for reassurance about his advice on taking them both at once. I’ve done it before with no issues but that was way before this PMR “gift” this year.

Very interesting. It certainly makes sense & is why I was wondering about hitting my body w/2 vaccines at once with this condition. I have 2 very young grand babies now who go to a play environment at the YMCA every few days. Lots of germs. So I need to be safe.

It sounds like you're in a situation that makes it wise to have both vaccines. Whether you have them together or a couple of weeks apart is entirely up to you, not your doctor. There's no medical benefit in having them at the same time.