Vaccinations for respiratory illnesses and PMR: To get or not to get?

This is a worry for me too. My initial PMR flare happened late November 2025, about 6 weeks after getting the flu and covid vaccines. Coincidentally, last year was the first time the vaccines made me feel badly afterward (sore, fatigued, slightly feverish). In hindsight, PMR may have been brewing, with this new, heightened immune response to my routine fall vaccinations foreshadowing its onset. I don’t want to be vulnerable to flu and covid by not getting the vaccines, but I don’t want to add to my maladies either if getting them isn’t value-added. Besides, don’t vaccines work by triggering an immune response on a small scale so the body is ready to fight an exposure? How does that work with a prednisone-suppressed immune system? I plan to discuss with my PCP in a couple of weeks during my next visit. Online research seems to be divided.

@kathy22wright
I have the same hesitations about upcoming Covid and flu shots. I have always had them in the past without any trouble. My PMR did start last fall after my vaccinations but my Dr discounts that as a possible cause. In my 40’s I had fibromyalgia for some 5 years and my brother has had 2 x PMR. So definitely some genetics going on. I am 78 and my brother is 81. Will discuss with my Dr again.

Thank you all for posting, and I have the same question for my rheumatologist when I see her next week. Last year, in November 2025, I had the pneumonia vaccine (I had had the Covid and flu already) and started feeling real pain from PMR in the days after. I am very nervous to get any kind of vaccine this year, but as was mentioned, I am also afraid to get any of these illnesses while auto immune compromised. I will report back next week..

I will follow the guidance of my rheumatologist and PCP. They will weigh the pros and cons objectively with much more experience in the benefits given my current maladies.

I was very leery of getting the first Covid vaccination because like many others my PMR was the result of an adverse reaction to a prior vaccination in 2019. I did not want to die from Covid - so it was a real approach/avoidance issue for me.
I asked my allergist to verify that there were no common ingredients in the Covid vaccine and the vaccination I reacted to. Other than water and salt there were none. With the advice and guidance of my Infectious Disease doctor I received the 1st Covid vaccination.
I continue to get vaccinations as needed, flu, Covid, travel, etc. I never get two on the same day. We have agreed I should wait at least two weeks between vaccinations. This is because vaccinations accelerate your immune system to create the antibodies of the vaccination and we want to give my body time to calm down before the next vaccination. I have been known to wait a month or more if time permits.
Being on prednisone was never an issue other than you antibodies may not be as strong because of the steroid. They will be better than no vaccination at all, just not as strong as they could be if you were not on steroids. Your dose of 7mg is small. I am at that level this year, last your it was 15mg.

I like your plan of staggering the vaccinations.

@kathy22wright

Same with me. Three days after the flu and Covid shots. But who knows? I don’t want to be left unprotected. But I’m not over PMR yet. Tough call!

Ugh. This is a dilemma, isn't it? While I don't have any hard evidence that my PMR was brought on by vaccinations, it so happened that it started about three weeks after a series of vaccinations in September of 2023. I had the flu shot, four days later had the Covid-19 mRNA shot, and 5 days later the RSV shot. I was in a time crunch because I could get the shots for free in California (while visiting there) and was leaving for Japan two days after that last shot. I may never know if getting those shots spaced so closely together all triggered my PMR, but it is a decision I have regretted to this day.

Not a hard decision for me. I am 74 with PMR for 2 years currently on Kevzara and 2 mg prednisone and doing well. PMR began a few weeks after having Covid illness. Received Flu and Covid boosters last year with no problems
I also have Type 2 diabetes and 5 years ago had aortic valve replacement and bypass surgery.
I will live with a PMR flare if it happens rather than increased risk for bad flu or covid if unvaccinated. My rheumatologist, endocrinologist and cardiologist all agree 🤓

Coincidentally I got PMR shortly after getting a mild Influenza Type A on a cruise (seemed like the whole boat was sick and 6 people in our large group got tested when got back). Others in our group that weren't vaccinated were miserable and I had sniffles and a cough for 2 days. I can't imagine being unvaccinated and on both Methotrexate and tapering prednisone. Both my PCP and Rheumatologist are telling me to get both COVID and Influenza vaccines the end of September.