4th vaccine dose?

I have had a txt from GP to make an appointment for this, I am a bit confused tbh.


  • BettyMac
    BettyMac Member Posts: 184

    A fourth dose is advised for anyone who is at higher risk from severe covid infection. If you’re not sure you fall into this category it might be worth giving them a phone to check.

    The protective effects of the covid vaccine wear off after a while and the 4th dose is meant to gee-up our body’s defence system again.

    We had ours on Friday. I felt like I’d been kicked in the arm by a horse yesterday - but I feel fine again today.


  • Kazza52
    Kazza52 Member Posts: 74

    If I am invited to take the 4th dose I will certainly take it up to boost my immune system. As restrictions are being lifted Thursday the 4th booster needs to be rolled out immediately and not in the spring as a lot can happen between now and then.

  • GillyRA
    GillyRA Member Posts: 5

    I’m feeling very disappointed right now. Being CEV and immunosuppressed, I had assumed I would be entitled to a fourth vaccine. However, I have just been advised by my GP that this is not the case, as my methotrexate dose is too low. According to ‘Green Book’ criteria, you have to be on at least 20 mg and I take 12.5 mg. Has anyone else come across this? Versus Arthritis are you aware of this contingency?

  • jamieA
    jamieA Member Posts: 423

    This post from last year has a link to the JCVI guidelines regarding the 3rd primary dose - and then a 4th booster dose - with the levels of steroids/DMARDS/biologics that apply. It details the levels of particular drugs that are regarded as causing the vaccine to be less effective and it states the level of MTX needs be greater than 20mgs.

    Here's the JCVI publication


  • Moon
    Moon Member Posts: 28

    Thank you for that information that's really interesting. I've just been offered a 4th covid jab but am a little hesitant in having it as 4 jabs in less than 12 months seems a lot for an already suppressed immune system to cope with

  • JenHB
    JenHB Member Posts: 93

    I'm waiting to see if I get a message from the GP - had two jabs and the booster and was only diagnosed with RA a couple of weeks ago and will be starting MTX shortly (got an appointment with the MTX nurse on 8th March). The consultant said that I would be eligible for another jab when I saw them a couple of weeks ago.

  • scotleag
    scotleag Member Posts: 79

    Yes, I read that at the time. I was on 20mg methotrexate & thought I might not get a 4th jab as it clearly stated it had to be more than that. But I got my fourth exactly a year to the day since my first. There does seem to be some confusion over eligibility. Does no harm for anyone unsure to try and book a fourth via government website. The worst it can do is say you're not eligible and all you've lost is thirty seconds of your time.

  • SandiB
    SandiB Member Posts: 22

    I was told to take the letter I had for the 3rd jab to a walk in centre to get my 4 th 12 weeks after the 3rd

  • jamieA
    jamieA Member Posts: 423

    I had a really hard time trying to get the 3rd primary dose - my GP wasn't interested in helping and the vaccine helpline were unaware of it but the rheumatology clinic nurse sorted it for me. By the time of the 4th (booster) dose I found it much easier. I called the vaccine helpline and they were aware of it and booked me in for a couple of days later.

  • jamieA
    jamieA Member Posts: 423

    I thought that the reason for the 3rd primary dose was that due to the drugs we were on at the time of our first and second doses the ability of the vaccine to generate sufficient antibodies was possibly compromised. I assumed that if someone wasn't receiving any of the drug treatments listed by the JCVI at the time of their first and second doses their reaction to the vaccines in generating antibodies shouldn't be compromised.

  • Jade_E
    Jade_E Member Posts: 4

    I’m on biologics and I’ve had 3 vaccinations these ones I got contacted by the GP. I’ve just had my invite for the 4th this was done via phone call through my hospital.

  • MrDJ
    MrDJ Member Posts: 242

    First time ive heard about the 20mg mtx criteria.

    Dont forget though if you are also on Anti Tnf infusion treatment then you need the fourth jab no matter what dose of mtx you are on. Im not sure about all the different makes though but it defo included Infliximab/Remsima

    And there is discussion at the moment for a 5th and 6th over the next year but this has not been finalised yet.

  • AmyAcorn
    AmyAcorn Member Posts: 29
    edited 27. Feb 2022, 18:16

    I had my 4th dose today and the lady checking everyone in said to keep hold of your letter inviting you to have a 4th dose as apparently they'll be doing a 5th dose at some point (she said possibly in 6 months), and to keep an eye out on the government's website as hospitals etc have been slow to send letters out throughout all of this

  • Moon
    Moon Member Posts: 28
    edited 1. Mar 2022, 08:43

    I've received a text from my GP offering me a 4th covid jab but I'm really unsure about having it. I'm on 20mg methotrexate injections and various other meds so definitely fall into the high risk category but I just feel 4 doses in under 12 months is an awful lot for an already suppressed immune system to cope with. No one knows if there are any long term risks or health problems associated with these vaccines and I'm also aware that the cover an immunocompromised person receives from each jab is a lot lower than that of a fully fit and healthy person. Am I fretting over nothing or is this a genuine concern?

    Can anyone help with my concerns please?

  • Received my hospital letter yesterday for 4 th dose I’m on 6 sulfasalazine a day and 15 mg of methotrexate once a week ! Having it tomorrow x

  • jennand
    jennand Member Posts: 130

    iv had 4 doses as I’m on biologics. I shielded during lockdowns, still wear a mask ( most places) and continue to be careful , as I also care for my 96 yr old M in L. But - I’m uncertain about a 5th dose, especially as it’s likely that the immunosuppressed will be offered a 6th dose in the autumn. My logic is that the better weather is around the corner and will be easier to spend time outdoors. Also, other factors are playing a part in my caution. Is it better to have Covid whilst I still have antibodies from my vaccines ( last one in February)??? I’m taking high doses ( recommended) of Vit D & K. Vit B complex, Vit C & zinc. Along with the biologics I feel my immune system is being dragged from pillar to post. I ache all over, my joints are definitely screaming at me. I take into account that winter’s are not my best friend, but usually I’m better than this at this time of year.

    Im leaning towards giving my system a rest until autumn although not definitely decided yet.

    What decisions have others made?

  • jamieA
    jamieA Member Posts: 423


    I've had 4 vaccinations and personally I'll take any future repeated covid vaccination. It's possible that it was covid that brought me to this site in the first place - so I wouldn't wish it on anyone. When I first took ill in March 2020 my GP telephone diagnosed it as a chest infection and sent me antibiotics. It repeated monthly and in May 2020 I was sent to a Covid triage unit where the consultant was pretty sure I'd had covid back in March but had no means of testing me. By October 2020 I was diagnosed with psoriatic arthritis then in November pneumonia - I've had at least 10 chest infections since it all started. In July 2021 one of the senior rheumatology staff told me that it wasn't unusual for PsA to be triggered by a virus. Since then I've read a number of reports of medics reporting patients develop PsA after contracting covid.

  • JB_PSA
    JB_PSA Member Posts: 8

    I’m on 15mg methotrexate and received a letter inviting me to have my 4th dose. Off I went along today and was screened and the minimum is 20mg methotrexate or if you’re on any steroids as well. So I was told no and off I came back home again. The person who screened me said I’d be offered my spring booster later in April and I will be eligible for that. So I am in the category of immunosuppressed but not severely immunosuppressed.

    There was also confusion when they sent me a letter about the third vaccine at the same time as the autumn booster so who knows what I am supposed to have had.