17 August 2021
COVID-19 Vaccine and Psoriasis
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.
When will I be offered the COVID-19 vaccine?
As of mid-August 2021, everyone aged 16 and over in the UK is now eligible to receive the COVID-19 vaccine, following an updated recommendation from the Joint Committee on Vaccination and Immunisation (JCVI).
Initially 16 and 17 year olds are being offered a first dose only, with a further recommendation on the timing of the second dose to follow, allowing the JCVI to provide the best available advice with the latest available information for the second dose, whilst providing some immediate protection from severe COVID-19.
The JCVI had already previously advised that:
- Children and young people aged 12 years and over with specific underlying health conditions that put them at risk of serious COVID-19, should be offered COVID-19 vaccination.
- Children and young people aged 12 years and over who are household contacts of persons (adults or children) who are immunosuppressed should be offered COVID-19 vaccination on the understanding that the main benefits from vaccination are related to the potential for indirect protection of their household contact who is immunosuppressed.
During phase 1 of the vaccination programme, the NHS offered the COVID-19 vaccine to people most at risk from coronavirus. You can find more information about psoriasis and the first phase priority groups for COVID-19 vaccination here.
I am in the 'clinically extremely vulnerable' group, should I continue to take extra precautions after I have received the COVID-19 vaccine?
No vaccine is 100% effective and therefore even if you have had both doses, there is still no absolute guarantee that you will not become ill from COVID-19. As such, you are advised to continue to take the extra precautions set out in the specific guidance for people who are clinically extremely vulnerable. There is individual guidance for England, Northern Ireland, Scotland and Wales.
Will data be collected on the effect of the COVID-19 vaccines on people with psoriasis?
Registry data such as that from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) and PsoProtect should be collected to inform whether the COVID-19 vaccines either positively or negatively affect psoriasis outcomes. In addition, if you have psoriasis yourself, you can self-report to the PsoProtectMe study (whether you have had COVID-19 or not). If you do experience COVID-19 infection then you can also ask your healthcare professional to report this to the PsoProtect registry.
Finally, if you have received the vaccine, you can report any suspected side effect using the Coronavirus Yellow Card safety scheme.
Information from the British Society for Immunology about the different types of vaccines for COVID-19 and how they work can be found here.
The British Association of Dermatologists has also issued an FAQs document addressing COVID-19 vaccination for immunosuppressed patients, which can be found here.
Specific information on COVID-19 vaccination in England, Northern Ireland, Scotland and Wales can be found by following the relevant link below:
For more information relating to COVID-19 and psoriasis, please visit our COVID-19 information hub.
Please note, this content was first posted on Wednesday 2nd December 2020 and last updated on Tuesday 17th August 2021.