Psoriasis and COVID-19 Vaccine Boosters – Everyday Health

In mid-August, the Centers for Disease Control and Prevention (CDC)recommended that people who have compromised immune systems get an additional dose of the COVID-19 vaccine.

This includes people who have received organ transplants or are undergoing cancer treatment, as well as some individuals with chronic health conditions who are taking drugs that can suppress their immune response, raising their risk of serious, prolonged COVID-19.

If you have psoriasis and are taking an immunosuppressive medication, such as high-dose steroids or a biologic, you may wonder what the new vaccine guidance means for you and when, how, or even if, you should get a booster shot.

Here are some answers to your most pressing questions, with insights from two leading psoriasis experts.

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Anyone with psoriatic disease who is being treated with immune-modulating drugs and has already received two doses of a COVID-19 vaccine from Pfizer-BioNTech or Moderna is eligible for a third dose, says Joel Gelfand, MD, the cochair of the National Psoriasis Foundation and a professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

Among those patients, Dr. Gelfand believes the following are most likely to benefit from a third shot:

Right now, psoriasis patients and other immune-compromised people who received the Johnson & Johnson (J&J) single-dose vaccine are not eligible for a booster shot.

Since the J&J vaccine has only been available since March 2021, the CDC is waiting for more data before making a recommendation about additional doses for people who are immune-compromised, as well as for the general population.

Preliminary data released by J&J on August 25 suggest that a booster shot could be highly protective.

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You should talk to the physician you see for psoriasis treatment to [get their input] and determine if you are on an immunosuppressive medication prior to getting the booster shot, saysLisa Zaba, MD, PhD, a clinical associate professor of dermatology at Stanford University School of Medicine in Palo Alto, California.

You dont need a prescription or a doctors note to get a third shot, but you should bring your vaccination card. The dose will be the same as the first and second shot, and the side effects should be similar, says the CDC.

If possible, yes, says Gelfand. The CDC is recommending that people get the same vaccine they received for their first two shots, so if you are already inoculated with either Pfizer or Moderna, you should get the same for your third shot.

If that isnt feasible, or you dont know which vaccine your received for your first two doses, the agency says you should get your additional dose with either the Pfizer or Moderna vaccine.

For people who are immune-compromised or taking immune-suppressing medications, its recommended that they wait at least 28 days after they had the second dose before getting a booster, says Zaba.

Not necessarily, says Gelfand. Of the treatments commonly used for psoriasis, only methotrexate has been found to result in modest reductions in antibody response to the mRNA [messenger RNA] vaccines [from Pfizer and Moderna]. And the clinical significance of this finding is not known.

Gelfand also notes that the U.S. Food and Drug Administration (FDA) authorized expanded use of two-dose Pfizer and Moderna vaccines on the basis of data from patients who received an organ transplant and, as a result, were significantly immunosuppressed.

Research has shown that these patients were not able to mount a significant immune response to the initial two-dose vaccine and that a third dose could help increase the amount of protective antibodies in their blood.

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Its very important to talk to your doctor before making any changes in your psoriasis medication, says Gelfand.

He notes that patients taking methotrexate with well-controlled disease may in consultation with their doctors consider pausing their medication for two weeks after getting the booster.

While this approach may improve antibody response, its not known if it will result in any meaningful benefit in terms of the risk of contracting COVID-19 or developing severe disease, he says.

Because the effects of pausing methotrexate after getting a COVID-19 vaccine arent yet known, people with psoriasis who paused their medication after the first two COVID-19 vaccine doses should still consider getting a third shot, says Zaba.

A third dose will likely provide you with better protection, but how much better is not yet clear, says Zaba.

Some studies have found that people who were severely immunocompromised and had virtually no protection from the Pfizer or Moderna vaccine had an improved antibody response after a third shot of the same vaccine, says the CDC.

Right now, we dont know if a third or booster shot has clinically meaningfully benefits [for psoriasis patients on immunosuppressive medication], says Gelfand. But given the emergence of the Delta variant, which is much more transmissible than previous variants, its likely that booster vaccines will be necessary and helpful.

Even after receiving a third dose of the vaccine, youll need to take extra precautions to avoid exposure to COVID-19, such as wearing a mask (especially inside) and avoiding crowds.

To reduce your odds of exposure, its also important that your family members and other close contacts get vaccinated.

If they are already immunized, they too will be eligible for a third shot beginning on September 20. Thats when the federal government is planning to roll out boosters for all Americans who received their second vaccine dose at least eight months prior.

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Psoriasis and COVID-19 Vaccine Boosters - Everyday Health