Vaccines, COVID-19 and you
The advent of an effective vaccine for Covid-19, is wonderful news and represents a truly astonishing scientific achievement. In the coming months, the government plans to roll out a comprehensive vaccination programme, with the aim of eventually protecting the entire UK population.
If you have psoriasis and psoriatic arthritis, you will obviously have important questions, including whether it is safe for you to be vaccinated against Covid-19. A number of organisations have issued expert guidance on this and other relevant issues, including:
- British Society for Rheumatology
- The British Association of Dermatologists
- Versus Arthritis
- The US, National Psoriasis Foundation (NPF) COVID-19 Task Force
- The International Psoriasis Council (IPC)
What follows is based on the advice of these organisations, along with relevant information from other expert groups. Before addressing specific questions, a note about the Covid-19 vaccines themselves is important and relevant.
The Covid-19 vaccines
Until now, most vaccines involve taking the live virus itself and modifying it in the laboratory so that it is no longer dangerous – so called live-attenuated virus. In psoriasis patients receiving immunosuppressive medication, it is recommended that live-attenuated vaccines be avoided.
However, the three vaccines currently being deployed against Covid-19,
(1) Pfizer/BioNTech, (2) Moderna and (3) Oxford/AstraZeneca - use an entirely different technology and are NOT live attenuated vaccines.
Questions and Answers
Is it recommended that patients with psoriasis should be vaccinated against Covid-19?
Yes. The expert guidance recommends that patients with psoriasis should be immunised against Covid-19 as soon as the vaccine is made available to them.
Should I have the Covid-19 vaccine?
The decision whether to have the vaccine or not, is a personal one. You should consider all the available information and make a decision based on your own circumstances. If you are unsure, you should discuss this with your own doctor.
Will the vaccine make my skin condition worse?
There is currently no evidence that the vaccine will make your psoriasis worse and no reason to think it would. Whilst it is true that we do not yet have specific information about the Covid-19 vaccine and psoriasis, evidence from other vaccination programmes (e.g., the flu vaccine) does not suggest any detrimental effect.
There are several Covid-19 vaccines - is one vaccine more suitable than another for people who are on drugs to suppress the immune system?
It is not yet known whether one vaccine is more suitable than another, for people who are on medication designed to suppress the immune system and it will be some time before we can give clear guidance on this. In the meantime, the recommendation is that you should receive whatever vaccine you are offered, since delaying will leave you at risk from Covid-19.
Is it safe for me to have the Covid-19 vaccine if I am taking immunosuppressant medication?
The short answer is - yes. As described earlier, Covid-19 vaccines are non-live vaccines. This means that they can generally be given quite safely to people receiving drugs such as methotrexate and biologic injections, that affect the immune system. As research continues on Covid-19, doubtless more specific information regarding different medical conditions will become available.
Is the COVID-19 vaccine effective in people taking immunosuppressant medication?
It is not yet known whether the vaccine will be as effective in patients on immunosuppressive medication, such as methotrexate and biologic injections. More research in this specific area is needed and will eventually become available.
However, given that there is no reason to think the vaccine will not be effective, the advice is that patients on psoriasis immunosuppressant medication should not delay being vaccinated against Covid-19.
If you are unsure, speak to your healthcare team.
Should I stop my medication if I decide to have the Covid-19 vaccine?
In general - no. Expert guidance says that patients may continue their oral or biologic psoriasis or psoriatic arthritis treatment without interruption, when receiving these immunizations. As always, however, discuss this with your family doctor.
Is it safe to have the vaccine if I have already had a Covid-19 infection or a positive antibodies test result?
The short answer is - yes. There is currently no evidence of any safety concerns from vaccinating people with a history of Covid-19 infection or with detectable Covid-19 antibodies.
Please note that the above are general guidelines. If you are still unsure as to whether vaccination against Coviod-19 is right for you, please discuss it with your family doctor.
Dr David Ashton MD PhD
First published 21 December 2020. Updated 6 January 2021