Vaccination in Immunosuppression — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRheumatology PharmacologyVaccination in ImmunosuppressionSCE Rheumatology

A 55-year-old woman with RA on Methotrexate is due to receive a COVID-19 vaccine. What is the recommended approach regarding Methotrexate and vaccination?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Withhold Methotrexate for 2 weeks after vaccination

ACR and BSR guidance recommends withholding Methotrexate for 1-2 weeks after COVID-19 vaccination (and other inactivated vaccines) to optimise the immune response, provided the patient's RA is well controlled. This recommendation is based on evidence that Methotrexate blunts the antibody response to vaccination. Methotrexate should not be withheld before the vaccine. Live vaccines remain contraindicated on Methotrexate. The timing of Rituximab relative to vaccination requires separate consideration (ideally vaccinate before the next cycle).

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions