Covid Booster and Flares

jamieA

I had a covid booster on 1st May - my 9th covid injection and the 4th Moderna in a row. For the first time I had a reaction to it. For 3 days afterwards all my joints were aching - not just those historically affected by my PsA. I then had my recommended 2 weeks off methotrexate after the injection during which things were ok after those initial 3 days. However by later in May - when I had restarted MTX - I started to get stiffness and increasing soreness in the joints that have been affected by my PsA - shoulders, hands, wrists, right SI joint, right hip and right ankle which is still ongoing. So I appear to be having a flare. I've been reading a number of medical papers and reports over the weekend about studies into flares caused by covid vaccinations and there appears to be mounting evidence that this can happen in a minority of cases. The various studies show that around 10 percent of immune mediated inflammatory disease (IMID) sufferers studied experienced flares at the 4 week post vaccination time.

I wonder if the flare is linked to the two week MTX break. Last year when I took a reduction in sulfasalazine I had a flare 4 weeks after the reduction and my rheumatologist increased the sulfasalazine dose back to the original level.

All the papers I've read suggest that a bout of covid causes flares in around a third of IMID patients so it's still far more beneficial to have the vaccination.

frogmorton

Hope you're feeling better now Jamie?

Glad you had your jab at least and as you said it was worth it.

I don't know whether it's of interest but this time I have heard of a fair few older people (having the jab due to age) struggling for the first time after theirs so maybe it's a stronger vaccine this time? Who knows.

Either way i hope things have settled for you and you are feeling much better now

Take care

Toni

jamieA

Hi @frogmorton

Thanks for your concern I appreciate it.

Unfortunately this flare hasn't abated - I think it might be my enthesitis that's causing this as it's affecting my forearms and upper arm as well as my joints. I've an appointment with my rheumatologist on Thursday - though I've just had a call from her secretary asking if it could be made a telephone consultation as the rheumatologist has contracted covid. So it's still out there and I'll continue to take any further boosters as they come along. I think maybe it's the 2 weeks off MTX that's caused this flare - as my sulfasalazine reduction did last year. My rheumatologist very much believes that the 3 drug treatment I'm on is what's working for my PsA and changing that may upset the balance.

I'm hoping she'll refer me for a steroid shot to try to calm this down.

I think Moderna's vaccine was updated in September 2023 so it's likely that the shot I got on 1st May was probably this update. My autumn vaccine in October 2023 may well have been the previous variation.

Woofy

I have had two Moderna vaccines, on both occasions was quite poorly.

The last one I had chronic diarrhoea for two weeks. I had to see a GP who said she thought it a reaction to the said vaccine, and made a note of this on my records. She also informed the yellow card scheme.

I am in favour of having a vaccine, but not the Moderna. I am not sure if there is another out there that I could have instead.

I have had the other two with no side effects.

frogmorton

Ah Jamie that's a shame. Hope the Rhuematologist T/C is helpful on Thursday. Tricky as you need the jabs, but we do need that two weeks off l thought for the vaccine to be allowed to do it's thing. Ah well.

Sending ((())) and hope you're back on track soon.

Not sure Woofy if there are are other options out there thought it was moderna this time. Just goes to show we are all different doesn't it?

Tak ecare both

Toni x

jamieA

Hi @frogmorton

I had a long conversation with my rheumatologist on Thursday - she's really good at explaining things without using complicated medical terms. I'm really surprised she's still working while she has covid - even from home. That's dedication for you. She arranged for me to have a general steroid injection yesterday afternoon at the clinic and last night I had my first uninterrupted sleep in almost a month. No waking at 3-4am, no swelling of my right arm and wrist and I can put my shirt on without my shoulders letting me know they are not happy. She also contacted my GP to arrange for prescriptions of ibuprofen gel and 30/500 cocodamol which were delivered yesterday. She advised me to take them when necessary. She said my latest CRP and ESR levels are low but that my physical symptoms show the disease isn't fully under control - particularly the enthesitis. She said this can happen in a minority of cases. She suggested we give it 3 months and if the symptoms return she will look at possibly changing my biologic. I'm a bit concerned with that as even with this last months setback the difference between me now and the way I was in July 2021 before the introduction to Amgevita(adalimumab) is really significant. I'm still able to walk my dog 50-60kms a week - albeit slowly and with a limp - whereas I was on crutches 3 years ago. She thinks I can be better - with lower symptom levels.

One interesting thing she asked was if I had a date for my left knee replacement as she said they can't make changes to the biologic drugs within a fairly long timeframe before that operation. I said I'm 6 months into a 2 year wait so she said that would be ok - we'd still have time to make any necessary changes to my biologic.

Thanks again for the concern.