COVID-19 Repository of vaccination recommendations

The EADV Task Force Atopic Dermatitis published some recommendations for Atopic Dermatits patients and COVID19 vaccination.

"The SARS-CoV-2 pandemic continues to have a considerable impact on the provision of appropriate care to people with psoriasis. In many countries there is currently great excitement about the potential initiation of vaccination programmes to people at risk and the general population. The impact of psoriasis therapy, particularly systemic therapy, on the effectiveness and safety of vaccines needs to be considered."

Recommendations for psoriasis patients (paediatrics, young people and adults) on systemic therapies

Currently, more than 50 COVID-19 vaccines are in human clinical trials.
• Several vaccines (Pfizer-BioNTech, Moderna, Oxford-AstraZeneca, J&J, and others) are already available or will be available soon, as soon as they are licensed by the Medicines Agencies.
o These vaccines use messenger RNA (Pfizer/BioNTech and Moderna) or a genetically modified viral vector with no replication capability (Oxford/AstraZeneca, J&J). Therefore, they are not live or attenuated vaccines.
• Patients with psoriasis, with no known contraindication or allergy to components of vaccines, are indicated for COVID-19 vaccination as soon as possible, depending on the availability and the Portuguese vaccination plan.
• As with other vaccines, the main considerations remain:
o Live or attenuated vaccines are contraindicated in patients on systemic immunomodulatory / immunosuppressive (IM/IS) therapy, which is not the case with these vaccines for COVID-19;
o The effectiveness of vaccination may be impaired in patients on systemic IM/IS therapy.
• The clinical trials of these vaccines have not included patients on systemic IM/IS therapy, so their efficacy and safety in this specific population has not yet been established. However, it is anticipated that, as with other non-live vaccines, these vaccines for COVID-19 are safe in patients with psoriasis, including those on systemic IM/IS therapy. Whenever possible, vaccination should be administered prior to the initiation of systemic IM/IS therapy.
• Although there is the possibility that COVID-19 vaccination may be less effective in patients on systemic IM/IS therapy, its indication for these patients remains: protection will be superior to non-vaccination and even if infected, will reduce the risk of hospitalization and serious complications, will accelerate clinical recovery and reduce the risk of contagion to others.
• In addition, patients should be advised that, even after vaccination is completed, protection measures must be maintained, since immunization is not immediate.
• Some patients may question the possible effect of the COVID-19 vaccine on the severity of their psoriatic disease. There is no evidence that vaccination (in general) is associated with worsening of psoriasis. Therefore, this is not expected to happen with vaccination for COVID-19.

This document has been prepared according to current knowledge, which may change as new vaccination data accumulate.

Summary :
• The safety and efficacy of SARS-CoV-2 vaccines in patients with immune-mediated dermatologic diseases requiring immunotherapeutics is unknown.

• The SARS-CoV-2 vaccines approved and distributed are expected to be safe for patients on immunotherapeutics with some variability in efficacy, depending on the degree of immunosuppression and type of vaccine given.

«Immune-mediated diseases and immunotherapeutics can negatively impact normal immune functioning and consequently vaccine safety and response. The COVID-19 pandemic has incited research aimed at developing a novel SARS-CoV-2 vaccine. As SARS-CoV-2 vaccines are developed and made available, the assessment of anticipated safety and efficacy in patients with immune-mediated dermatologic diseases and requiring immunosuppressive and/or immunomodulatory therapy is particularly important.»

To appear in: Journal of the American Academy of Dermatology
Published : 15 January 2021

In January 2021, the Spanish Group of Psoriasis ( GPS) of the Spanish Academy of Dermatology and Venereology published some recommendations about psoriasis patients and COVID-19 vaccination.

The February 11th 2021 the NVDV published a FAQ concerning COVID-19 vaccination and immunosspuressants.

In january 2021, the Journal of Allergy and Clinical Immunology published an article concerning psoriasis and atopic dermatitis diseases and the risk to contract COVID-19.

The IPC (International Psoriasis Council) published an commentary to explain and summarize the Journal of Allergy and Clinical Immunology’s article.