Compared to the general population, people with autoimmune diseases have a slightly increased risk of developing severe Covid-19 if they are infected with Sars-CoV-2. The current recommendations, including those of the International Psoriasis Council, reveal no particular contraindications to the use of available vaccines and advise doctors and other healthcare professionals to administer anti-Sars-CoV-2 vaccines to patients with severe chronic inflammatory skin diseases, unless which have no specific contraindications to vaccination.
“At the moment, no contraindications to the Sars-CoV-2 vaccine have been found for people with autoimmune diseases, except in the case of allergies to vaccine compounds. Immunosuppressed people, due to their pathology or the drugs they take, may have a greater risk of responding less effectively to the Sars-CoV-2 vaccination ”. This was stated by Rita Murri, infectious disease specialist, researcher in Infectious Diseases at the Catholic University of the Sacred Heart and the Gemelli Irccs Polyclinic Foundation in an interview published on the Aleati per la Salute website (www.alleatiperlasalute.it) the portal dedicated to medical-scientific information made by Novartis.
None of the available Covid-19 vaccines are derived from live attenuated viruses, which are contraindicated in patients with psoriasis and on biologic or immunomodulatory or immunosuppressive drugs. At present mRNA vaccines (Pfizer-BionTech and Moderna) and with adenovirus unable to replicate (AstraZeneca and Johnson & Johnson) are authorized in Italy.
The data currently available do not allow to exclude that biological drugs or conventional systemic drugs can reduce the immune response to the vaccine and therefore its potential efficacy. By virtue of these observations, the majority of psoriatic patients with no known contraindications or allergies to vaccine components should be given one of these Sars-CoV-2 vaccines as soon as possible without stopping their biological or systemic therapy for the treatment of psoriasis. and / or psoriatic arthritis in most cases.
Given that each patient has a different situation that should be evaluated by their own dermatologist, the National Psoriasis Foundation COVID-19 Task Force recalls that: no adverse events from vaccination have been recorded in patients treated with biologic drugs (anti TNF, anti IL-17 and anti-IL23) therefore patients under treatment must get the vaccine. The vaccines currently available, although different in their mechanism of action, are all effective; although immunosuppressive drugs can reduce the efficacy of the vaccine, there are no contraindications to its administration. It is however recommended, for some classes of biological drugs, that the vaccination is done temporally away from the administration of the immunosuppressant, it is necessary to agree on a possible delay in the administration with your doctor based on the disease activity; in case of therapy with cortisone, even if there could be a less efficient immune response, the administration of the vaccine is still recommended.
“The media attention on the anti-Sars-CoV-2 vaccination and the communication on the efficacy and, above all, on the safety of the vaccines currently available have created more doubts than certainties – explains to ‘Allies for Health’ Francesca Romana Spinelli, rheumatologist at La Sapienza University of Rome -. Never before is it important to clarify the (few) risks and the (many) benefits of the largest vaccination campaign in recent decades ”. The full service is available on: https://www.alleatiperlasalute.it/salute-20/terapie-biologiche-e-vaccinazioni-covid-19