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Fortunately, denosumab should not impact the ability to receive the measles vaccine safely. However, this is not the case for many other medications used in rheumatology. The Measles vaccine (MMR) is a live attenuated vaccine. While it is safe in most situations and quite effective, we do need to be very careful for those who may be receiving medications that modulate the immune system. This means the majority of disease modifying medications in rheumatology would need to be held for a few months prior to receiving the MMR vaccine safely. Denosumab does not affect the immune system in the same way so should be considered safe in most circumstances. For more information on vaccine safety in rheumatology, please visit our vaccination information webpage. It is always best to check with your rheumatology team to see how to best approach this situation should you need an MMR vaccine, or any other live attenuated vaccine.

Brenda from Edmonton asks: Can I get the MMR vaccine while on methotrexate?

In most cases, we feel getting MMR on methotrexate is ok, even though it is an attenuated live vaccine. MMR should not be given to those on biologics however. For a full list of our vaccination recommendations, please visit our vaccine webpage!

Emma from Canada asks: I received my 2 doses of the Moderna vaccine and with the first experienced a 1 week rheumatoid arthritis flare but it was manageable. After the 2nd dose, my RA took a turn for the worst & I have been in the worst flare of my life since (4 months now). Should I still get the booster?

The best advice for anyone in this situation is to speak with your rheumatologist. Regardless of the vaccine, a flare lasting more than a few weeks deserves a conversation with your rheumatologist to determine the best course of action going forward to get it under better control. That said, while there is some evidence that the COVID vaccine may induce flares in a small minority of cases, most times the flare is either a side effect of the vaccine but perceived as a flare (likely what is described after the first shot) or a coincidence of association, rather than causation. As so many people are getting COVID vaccine, it will happen that some will flare afterwards, but it is likely that many of those flares would have happened anyways. As a general principle, 3rd (and now 4th) shots for COVID vaccine are encouraged for those with rheumatic diseases.

Norma from Alberta asks: I have stable lupus. Can I get the COVID-19 vaccine?

Please visit our COVID-19 vaccine information page, which we will keep updating as more information becomes available. At this time (January/2021), there is no information to suggest the currently available COVID-19 vaccines are unsafe for those with lupus or taking any medications for lupus. That applies to all rheumatic conditions, in fact. If you are still not sure after reading the available information, please contact your rheumatologist.

Michele from Camrose asks: I was diagnosed with mixed connective tissue disease and am taking plaquenil. Should I be getting a flu shot and also I am in need of my second MMR immunization. Is it safe to proceed?

As a general rule, most vaccines are safe for those with a rheumatic disease and on treatment. In fact, patients are encouraged to receive an annual influenza vaccination.

Caution is required for live vaccines, such as MMR (measles, mumps and rubella), depending on the medication you are taking. Visit our vaccination page to find out more, but always discuss the details of your particular situation with your physician.