talkhealth forums

Hello,

I hope you're well today. This is the second question I’m asking, so I hope that’s okay. I'm being greedy!

My father has rheumatoid arthritis and takes Methotrexate. He’s also elderly and in the highly vulnerable group with this immunosuppressant medication so he’s been shielding since March. The pandemic is getting to both of my parents quite a lot and I think it’s making my dad more depressed as he’s not sure he’d even be able to take a vaccine. I know nobody knows anything really about these potential vaccines yet, but if it’s a live vaccine I imagine that might cause problems. With RA and Methotrexate, do you think a vaccine might be safe? I don’t know whether it’s worth speaking to the rheumatologist about going onto another medication or not. The Metho isn’t doing quite enough but I’m concerned about him staying on it if it stops him from being able to take a vaccine when they become available. Any thoughts on this would be much appreciated

Many thanks & kindest regards,

Caz

Hello,
Your father should definitely not stop methotrexate as having active rheumatoid arthritis carries a significantly increased risk of many infections so he is much safer on the methotrexate overall than off it, although he may need a higher dose or another medicine as well if his arthritis is still active. Live vaccines, for example yellow fever should not be given to patients on methotrexate but there are very few of these and, like the influenza vaccine, the Covid vaccine is expected to be safe and will be offered to those most at risk first.

Dr Wendy Holden
Consultant Rheumatologist and Medical Advisor to Arthritis Action
https://www.arthritisaction.org.uk/
020 3781 7120

Thank you very much for your response, Wendy. He's not confident about swapping to a different medication, even though it's been suggested by the Rheumatologist, because of it being risky, and I'd be worried to do this at present anyway. I wasn't sure what the vaccine for Covid would likely be in terms of live or not, so it's very reassuring to read that you think it's likely going to be safe and suitable for those on immuno-suppressants. Fingers crossed. My father will be very happy to hear it! Thanks again for your response