Humira and flu shot

I spoke to my doctor about getting the flu shot. He told me I would have to be off Humira for three weeks, then I can have the flu shot. However, then I would have to wait two more weeks to go back onto Humira. I asked the doctor if the Humira will work for me again, after a 5 week hiatus, he said he did not know. I was wondering has anyone else been given this same advice as to how to get ready for the flu shot? When I called the Humira nurse line I was told she did not know of any sort of plan like this. Also, can anyone tell me their opinion or experience, if taking a break from Humira , did it work for you when you went back on it.

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From the National Psoriasis Foundation:

Psoriasis and the flu: What you need to know if you are taking an immunosuppressive drug


Flu season can be a serious health threat for people with psoriasis and psoriatic arthritis who are taking immunosuppressive drugs.

National Psoriasis Foundation recommends that patients taking immunosuppressive medication including biologic (Enbrel, Humira, Stelara, Simponi and Remicade) or systemic (cyclosporine or methotrexate) drugs take the following precautions:
Get vaccinated early. The same medications that suppress psoriasis make people more vulnerable to the flu.
Receive only inactive vaccines. Seasonal flu vaccines come in inactive (given as a shot) and active forms (given as a nasal spray). People taking medications that suppress the immune system should only receive the inactive vaccines.
Take more daily health precautions. The Centers for Disease Control (CDC) recommends avoiding close contact with people who are sick, washing your hands frequently, and avoiding touching the eyes, nose and mouth.

If people with psoriasis or psoriatic arthritis develop the flu while taking an immunosuppressive drug, it may be necessary to temporarily stop the treatment—known as taking a "drug holiday"—to get better. Be sure to talk with your doctors if this occurs.

Learn more about the flu and psoriasis »


There is NO discussion about stopping the biologic before taking the shot. I would suggest looking further at www.psoriasis.org. There's an easy search feature on their website. You could also call them ( they have their 800 number on the website).

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I've always had flu shots while on both MTX and biologics. The same doc who put me on the meds administered the flu shots.
Never a problem.

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Some doctors are funny about the flu shot. If you're not allergic to it go ahead and get it. It's not going to hurt you and it might keep you from getting the flu. My doctors tell me to get the shot.

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I've never stopped my biologics. I take it like clockwork and I've had 2 flu shots since starting

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Yes, you can get a flu shot, I am on Stelara and it's fine. Just be aware to get the shot only. If you feel like you need to stop it, I had to off of Humira for surgery last year and was off for about a month and went back on just fine. Symptoms may worsen. Usually they tell you if you have any kind of surgery or infection you need to go off. Hope this helps!

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Thank you all for you input. I love my doctor, I have to say he was never in favor of me going on Humira. Perhaps this is why he is being so careful, telling me I should take a Humira Holiday if I want a flu shot. My husband wants me to just follow what I have read and just have the flu shot... I have to decide soon.

Those who have gone off Humira, overall after the break and then back on, did the medicine still work, did the Psoriasis become much worse?

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One person here took a holiday from Humira and she got worse for awhile. Finally the doctor got things under control.

Don't stop the Humira to take a dead virus flu shot. It makes not sense. Ask your doc why she's telling you that.

Don't take the live shot (nasal spray), take the dead one.

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Yes I skipped 2 humira injections last August as I was traveling, and developed severe joint pains all over my body, and my skin psoriasis all came back. I then resumed the humira but it wasn't working. The derm said to retake a loading dose: he had me take 2 injections per week for 2 weeks, then 1 injection per week (I normally had been on 1 injection every 2 weeks). The pains gradually got better but my skin is still not so good yet. Conclusion: it was a very bad idea to stop the humira and I don't recommend it.

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I went off Humira for good 4 months ago--Nail Psoriasis came back very bad and PsA terrible.
Decided to live with the pain and awful nails for a while. Humira (along with 20 mg. MTX weekly injections) worked wonders on joints and nail psoriases- but at a cost . Humira caused Hair and Weight Loss (which I didn't need)- and the combo of drugs altered my state of well being--BUT I was out of Pain and my nails cleared up completely.
There would be no reason to take a "drug holiday" unless undergoing surgery (need to be off before and after) or if sick with Infection for which Antibiotics are prescribed. I was off for those both reasons and went back on and med which continued to work.
First started meds Sept. 2010 with a very cautious MD. MTX alone for 9 months did nothing. Had s allergic site reaction to Enbrel. Humira worked (started Nov. 2011) with no immediate noticeable reaction--but my sense of taste changed dramatically.
Humira stopped working well on joint pain--other problems arose--so I went off.

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I've been on Humira for 4 years with the exception of my pregnancy, always received the flu vaccine and never instructed to take a holiday. Myself and everyone in my household must get the injection as opposed to the nasal spray as the nasal version is live vaccine. As for stopping Humira and starting again, I stopped using it during my pregnancy. My PsA was managed with Humira alone prior to my pregnancy, and seemed to go into remission during my pregnancy (only had one instance of joint pain/swelling and a prednisone pack got that under control). However, not even a week after my son's birth the severe joint pain and swelling returned. My knee was so swollen I could hardly walk and my hands hurt so bad it was difficult to care for my newborn son. I went back on the Humira and mobic for joint pain. I have been unable to get my PsA under control as well as it was prior to my pregnancy, my son will be 2 in February. I attempted a Humira holiday as my son needed the varicella vaccine-a live vaccine. I was to quit for two weeks, have him vaccinated, and wait an additional two weeks before my next injection. I didn't make it...almost two weeks into it (so almost 4 weeks since my last injection) not only was the joint pain and exhaustion taking over, but all fingers on my right except my pinky swelled up. I immediately began my Humira again but the damage was already done. After two months of occupational therapy I can almost make a fist again, but will never be able to straighten them again. Now both hands are disfigured and have limited mobility.

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wow MBH09, you seem to have had a similar experience to what I had. The rebound pain from not using humira is worse than the original PsA! Are you thinking of switching biologics to get better control of the PsA?
With humira shots once a week I am mostly ok except the day before my next injection, 2 fingers in my left hand start swelling and hurting. The day after the shot the pain goes away again. I don't know what that means, perhaps it means I am getting resistant to humira?

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I have no problem going off of mtx but ask me to stop my biologic and there has to be a really good reason not just some cya bullshit.

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Your doctor is uninformed. There is NO REASON to stop taking Humira and/or methotrexate to get a flu shot. Sad that someone who prescribes this biologic is so uneducated about it. Has he made any other mistakes that you could know about???

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Hi all, thank you so much for your advice about the Flu shot and Humira. I have a great doctor but pretty much everyone is saying his plan, that I must go off Humira for a total of five weeks, seems wrong? I think what I am going to do is shave off some of this Humira Holiday. I am going to take off maybe half of the weeks I was told to do. This way I am listening to both my doctor and you all. I am too afraid that my P will get worse if I take off all of five weeks. As it is after only about 8 months the P is coming back on my arms. The doctor has been hearing of such stories related to Humira and wondered if there is a bad batch out there. However, except for me going off of it for the flu shot, he suggest I still stay on it for awhile.

This is all not easy is it?

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I think you'll read on this site, biologics work only until they don't anymore!
Not a bad batch of Humira. Humira worked about 15 months for my PsA and Psoriatic Nails--I stayed on drugs another few months. I took Methotrexate the whole time.FYI: Methotrexate alone was useless, but doc believes it should always be used in addition to biologics.
For anyone else reading this and responding--my rheumy said only other biologic I should try is Simpani.
Any info to share?? Thank you.

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Get a new doc....I've has the flu shot on humira and stelara...no worries.

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I've been on Humira for 7 years and not once did it occur to me to stop it for a flu shot. Nor have I gotten sick from it or had other ill effects. Nor has my doc advised me to stop. You might want to check the Humira insert that comes with your syringes, or check the company website.

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I was on Enbrel for 3 years, on Humira for 3 years- off since July 31. I have had regular flu shots without problems. I also took a shingles vaccine last month (without problems), as my Dr. wants to try methotrexate and Remicade. Insurance is still considering (1 month now!).

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Geez, I was planning on getting my flu shot this weekend and just came down with a nasty cold!

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I have PA. I was on Enbrel for over 5 years...working very well. Went to my family doctor for annual checkup in February 2010. He recommended flu shot and H1N1 shots. I had the flu shot first, then the H1N1 shot. Within 10 seconds it made me really dizzy and flushed. But felt fine in about 20 min. Then a couple of months later in April, I almost passed out at work. Went to hospital, and everthing was normal. But ater a month of migraines, stuffy head, and weird dizzy spells, I went to an allergist...and found out I was now allergic to pretty much everything. Trees, grass, mold, weeds, etc. I can't prove it, but that cocktail of injections messed up my environmental immunities. Enbrel started to fail later that year. Had a full regimen of allergy shots and am doing much better at least with those symptoms. I'm now using humira with limited success. I heard Stelara did the same thing to some people. Anyone else hear this?

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