skip to main content

Methotrexate and Vaccination — SCE Rheumatology MCQ

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

ModerateRheumatoid ArthritisMethotrexate and VaccinationSCE Rheumatology

A 40-year-old woman with RA on Methotrexate is due to receive her influenza vaccine. According to BSR 2025 what is the recommendation regarding Methotrexate timing around influenza vaccination?

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

Reveal the answer and explanation

Correct answer: C — Withhold Methotrexate for up to 2 weeks after vaccination if disease activity allows

BSR 2025 csDMARD guidelines now include a specific recommendation (GRADE 1A) that Methotrexate should be withheld for up to two weeks after influenza or COVID-19 vaccination in adults assuming disease activity and risk of flare allows. This is based on evidence that Methotrexate blunts vaccine immunogenicity and that a 2-week hold improves antibody responses. In the paediatric age group an individualised approach is recommended at the clinician's discretion. This applies to inactivated vaccines only. Live vaccines remain contraindicated.

Reference: BSR 2025 - Guideline for prescription and monitoring of conventional synthetic DMARDs