During a recent PW Podcast episode, we spoke with Joel M. Gelfand, MD, MSCE, Professor of Dermatology and Epidemiology, Vice Chair of Clinical Research, and Director of the Psoriasis and Phototherapy Treatment Center at UPenn Perelman School of Medicine, as well as Co-Chair of the National Psoriasis Foundation (NPF) COVID-19 Task Force. Following is a summary of that interview:
Where does the NPF COVID-19 Task Force stand on COVID-19 vaccination for patients with psoriasis?
The two big questions for our community are whether the mRNA vaccines aggravate psoriasis as an underlying inflammatory disease and what would be the impact of psoriasis treatment on how well the vaccines work. Looking at a long history of vaccinations that have been used for decades, there’s almost no evidence at all that vaccines induce psoriasis or aggravate the disease in those who have it. Even with the shingles vaccine, which is highly immunogenic, patients have not had an aggravation of psoriasis. And, the CDC has commented that there is no evidence of autoimmunity being induced with the mRNA vaccines. So, we’ve come up with the unanimous recommendation that people who have psoriatic disease should get an mRNA-based vaccination as soon as they are eligible, if they haven’t already.
Patients may say, “I’m taking a biologic,” or “I’m taking methotrexate,” or “I’m taking another medication that targets my immune system. What do I do with these medications when I get vaccinated?” Here, again, we looked to the vaccine literature to date on the effects of psoriasis treatments on, say, the flu shot or on the pneumococcal vaccine. And we saw that the therapies we use to treat psoriasis, generally speaking, don’t have a clinically significant impact on how well vaccines work. Until there is new data that says otherwise, we recommend that patients get the COVID-19 vaccine and stay on their systemic therapies for psoriatic disease during the vaccine period.
This is a rapidly evolving area, and so our guide is designed to be a living document. Patients and healthcare professionals can go to the COVID-19 resource center on the National Psoriasis Foundation’s website, where we update our recommendations in real time, because new vaccines have come to market since we first wrote them, including the Johnson & Johnson vaccine. We review the new information, see what the CDC says, and then come out with a statement about how we feel about that vaccine, for example