Vaccine Response On/Off Methotrexate (VROOM) Study

jamieA

I've just received my invitation for the winter covid vaccine booster and flu vaccine and thought I should check the latest guidance on the timing of vaccines and treatment - specifically in my case for MTX and Adalimumab. I came across references to the VROOM study results from June 2022 which I hadn't heard of before. It suggests a 2 week pause from taking MTX after being vaccinated. The study suggests that doing so gives a 2 fold increase in antibody levels against the covid spike protein.

https://nras.org.uk/resource/vroom-interim-results/

There's a paragraph on this on the main VA website Vaccines For Covid your questions answered page

https://www.versusarthritis.org/covid-19-updates/vaccines-for-covid-19-your-questions-answered/

"The VROOM study , published in June 2022, showed that stopping methotrexate for two weeks after a COVID-19 vaccination doubled people’s antibody response for at least three months without causing major flare-ups of arthritis. While pausing methotrexate after vaccination may be a good idea for many people, we don’t recommend pausing any of your treatments without checking first with your healthcare team."

Loggiemod

@jamieA might be a good idea to ask your GP or Consultant for advice as well, or NHS 111

frogmorton

I was going to say something similar to @Loggiemod maybe check what the position is regarding your adalimumab?

jamieA

Hi @Loggiemod and @frogmorton

Yes I've left a message on my rheumatology clinic helpline asking for their recommendation. My vaccine appointment is on a Saturday and my MTX is every Thursday with my adalimumab due the Thursday after the vaccine. I'm still regularly using LFTs and I've avoided covid since the first vaccination whilst every other family member has had it at least once in that time. I've not had any adverse reaction to the vaccinations so I'm happy to continue to be vaccinated.

jamieA

Hi,

I've just had a call back from the rheumatology clinic. The nurse confirmed the study recommendation in general of a two week hiatus after the vaccine for MTX. However she said this may not suit everyone and to check with your own rheumatology clinic whether it's in your best interests. She suggested in my case that as I'm stable I should take a 2 week MTX holiday after the vaccination. She said the studies were from a larger sample of people so they were more confident in it's results. However as to my question of the biologic injection she said there isn't enough evidence to give a definitive answer. Again she said in my circumstances as I'm stable she'd suggest that I delay the injection I'm due to take the Thursday after the covid booster by a week but has left it up to me to make the final decision.

I wonder if it might be a good idea if VA were to put a statement on the website regarding the VROOM study.

noddingtonpete

Hi @jamieA thanks for the suggestion, I'll pass it on

jamieA

Hi,

Just a quick update on this - I had my flu and covid booster last Saturday late afternoon. I think I would change my allotted time to a day during the week if I were to do that again as it was really busy with probably about 50 people waiting at any one time. I ended up being there for an hour.

The medic asked me first which hand I used and said they had been instructed to give the covid booster in the opposite arm. The flu vaccine was to go into my other arm. When I asked why that was she said there had been reports of the Moderna Bivalent vaccine causing more aching than the previous boosters.

As it was I didn't have any problems with the covid booster but did have a couple of days of flu like symptoms - headache, temperature and aching joints - I'm assuming from the flu vaccine.

stickywicket

Interesting. Thanks, Jamie.

Just to show we're all different, I had my two jabs a week ago. Thurs lunchtime. Four nurses awaited a patient. (Mr SW had a similar greeting the week previous at 5.45pm.

My previous Pfizers (It was Pfizer again) all raised my BP to worrying levels and it had been up and down the week before so I asked if I could have both jabs in my dominant right arm as I needed my left for regular BP tests. (Last year I had both together in my left arm.)

I've had no problems at all. Even the BP is behaving so far.

JenHB

I've got my covid and flu jabs tomorrow morning (8am!) so hopefully there won't be too much of a queue then. I've also been advised to have a 2 week break from my MTX. Just though (as I've not been told otherwise) - I'm guessing I still take my folic acid as normal?

Hairobsessed123

I had mine end of September!I had booster the new spikevax and flu jab ! I had it on a Friday and missed my methotrexate dose on the Wednesday .

Firdt time I felt really Ill all weekend so I’m guessing my immune system responded to it !! Goodluck everyone !!