COVID-19 Vaccine and Psoriasis

From psoriasis-association.org.uk

Information about the COVID-19 vaccine(s), psoriasis and immunosuppressant medications

The COVID-19 vaccine provides the best protection against coronavirus. Four vaccines for COVID-19 have currently been approved for use in the UK: the Pfizer/BioNTech vaccine; the Oxford/AstraZeneca vaccine; the Moderna vaccine; and the Janssen vaccine. The Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines are now being given to people at sites across the UK. The Janssen vaccine will be available in the UK later in 2021.

While this is certainly cause for optimism, it’s completely understandable that people who are taking immunosuppressive drugs for their psoriasis and/or psoriatic arthritis may have some concerns about whether or not it is safe for them to receive a COVID-19 vaccine.

We’ve put the following information together to try and address some of the concerns you may have. It’s important to note that we are learning more about both COVID-19 itself and the different vaccines that are being developed all the time. We will ensure that this section is updated regularly as further information is released.

Is the COVID-19 vaccine suitable for people with psoriasis and/or psoriatic arthritis?

Yes, current evidence suggests that the Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines are all suitable for people who are living with psoriasis and/or psoriatic arthritis. Therefore, having psoriasis and/or psoriatic arthritis, or taking prescribed medicines to treat your condition will not affect whether or not you can receive the COVID-19 vaccine, or which vaccine is best for you.

Is a COVID-19 vaccine likely to affect my psoriasis?

There is no evidence to suggest that vaccines are bad for psoriasis (or likely to make it worse, or flare), hence why people are encouraged to have the flu vaccine each year. At this stage, scientists are having to extrapolate data from other vaccines such as the flu vaccine and can see no reason why the COVID-19 vaccine would be any different in terms of flaring/causing psoriasis from, say, the flu vaccine. Systematic reviews have not found evidence that (non-live) vaccines are bad for psoriasis.

Is it safe for people who are taking immunosuppressant medication to receive a COVID-19 vaccine?

Yes, the Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines are all considered suitable for people who are living with psoriasis and/or psoriatic arthritis regardless of whether they are receiving drugs that affect the immune system (such as methotrexate and biologic injections, for example) or not.

People who are receiving drugs which affect the immune system are not able to receive live (also known as 'attenuated') vaccines, however the Pfizer/BioNTech, Oxford AstraZeneca and Moderna vaccines are not live vaccines. Non-live vaccines can generally be given safely to people receiving drugs that affect the immune system (such as methotrexate and biologic injections, for example), however further study is required to understand how well the vaccines work in the context of these medications.

For further reassurance on this point, please refer to the British Society for Immunology statement on COVID-19 vaccines for patients who are immunocompromised or immunosuppressed.

Will a COVID-19 vaccine be effective in people who are taking immunosuppressant medication?

It is not yet known whether taking an immunosuppressant (such as methotrexate) or biologic medication reduces the effectiveness of COVID-19 vaccines. Trials to date have not included people taking drugs that affect the immune system and thus vaccine efficacy in this specific population will need to be established.

However, even a reduced response to the vaccine is better than none, so you are still advised to get vaccinated even if you are taking an immunosuppressant medication.

In July 2021, results of a study which investigated the immune response to the first dose of the Pfizer COVID-19 vaccine in people taking immunosuppressant drugs for psoriasis were published. You can find out more here.

I have been offered one of the COVID-19 vaccines - should I stop or delay my immunosuppressant or biologic medication?

The British Association of Dermatologists currently does not usually advise stopping or delaying immunosuppressant or biologic treatment before receiving the COVID-19 vaccine.

There may be situations where your doctor advises reducing or stopping your treatment - for example, if your risk of COVID-19 is high and your psoriasis or psoriatic arthritis is well-controlled and unlikely to flare up. This should be discussed with your doctor on an individual basis. Do not stop any of your treatments without first discussing with your doctor.

I am about to start taking an immunosuppressant or biologic medication for the first time - can I receive the COVID-19 vaccine?

Yes. Your doctor may offer you the COVID-19 vaccination before you start your treatment to give your immune system enough time to respond to the vaccine.

Ideally, the time between receiving your vaccine and starting treatment is at least 2 weeks. Where possible, it is also preferable for the two-dose schedule to be completed before starting treatment, which may mean that the second dose of the vaccine needs to be given at the recommended dosing interval for that particular vaccine (3-4 weeks after the first dose). However, this may not be possible depending on the severity of your psoriasis and the type of immunosuppressant or biologic medication you are about to start taking. Your doctor will discuss this with you.

https://www.psoriasis-association.org.uk/news/covid-19-vaccine-and-psoriasis