Update on Biologics and the Covid-19 Vaccine
Many of our patients are taking injectable “biologic” medications to help reduce the severity and symptoms of their skin condition. This includes patients with psoriasis, hidradenitis, atopic dermatitis, and other conditions. We have received numerous questions about the use of these medications during the pandemic, as well as their effect on the Covid vaccine. Here is the latest info:
Commonly used psoriasis biologic medications include Cimzia, Cosentyx, Enbrel, Humira, Ilumya, Remicade, Siliq, Skyrizi, Stelara, Taltz, and Tremfya.
Sanova Dermatology follows the recommendation of the National Psoriasis Foundation Covid-19 Task Force Guidance Statements:
1. Do patients with psoriasis have an increased risk of Covid-19, or a worse outcome with a Covid-19 infection? Short answer: No
-“Existing data, with some exceptions, generally suggest that patients with psoriasis and/or psoriatic arthritis have similar rates of SARS-CoV-2 infection and COVID-19 outcomes as the general population.”
2. Does biologic therapy increase the risk of Covid-19 infection and/or worsen the course of infection? Short answer: No
-“Existing data generally suggest that treatments for psoriasis and/or psoriatic arthritis do not meaningfully alter the risk of acquiring SARS-CoV-2 infection or having worse COVID-19 outcomes.”
-“It is recommended that patients who are not infected with SARS-CoV-2 continue their biologic or oral therapies for psoriasis and/or psoriatic arthritis in most cases. Shared decision-making between clinician and patient is recommended to guide discussions about the use of systemic therapies during the pandemic.”
3. Should patients on biologic therapy receive the Covid-19 vaccine? Short answer: Yes
-“Patients with psoriatic disease, who do not have contraindications to vaccination, should receive a mRNA-based COVID-19 vaccine as soon as it becomes available to them based on federal, state and local guidance. Systemic medications for psoriasis or psoriatic arthritis are not a contraindication to the mRNA-based COVID19 vaccine. It is recommended that patients who are to receive a mRNA-based COVID-19 vaccine continue their biologic or oral therapies for psoriasis and/or psoriatic arthritis in most cases.”
4. Is it recommended that patients on biologic therapy receive the Covid-19 vaccine booster shot? Short answer: Yes
– “Based on recent CDC guidance regarding booster COVID vaccination doses for individuals who are moderately or severely immunocompromised, we recommend that you receive a booster dose due to one of your medications. If you had two doses of either the Pfizer or Moderna vaccine, and it has been at least 28 days since the second dose, we urge you to receive a booster dose. We recommend you receive a third dose of the same vaccine you received initially.”
Many of our patients with eczema, or atopic dermatitis, are on immune-modifying medications such as prednisone, azathioprine, cyclosporine, methotrexate, mycophenelate mofetil, and dupilumab (Dupixent). The National Eczema Society has a succinct page on “Advice on Covid-19 for eczema patients”. Highlights include:
Should patients on eczema therapy avoid receiving the Covid-19 vaccine?
-Since the Covid-19 vaccine is not a “live” vaccine, it is appropriate for eczema patients on any therapy to receive a vaccine, and treatment does not need to be stopped or delayed after getting the vaccine
The National Eczema Association also offers guidance for eczema patients. For those seeking information on their risk of Covid-19 infection and the possible effects of eczema medications on the risk and course of the infection, click here. More information on the Covid-19 vaccine and its suitability for eczema patients can be found here
If you have specific or additional concerns we recommend you reach out to your dermatologist to find out more. As we get more information and data we will be updating this information to make sure our patients have access to the latest information available to help guide them as best we can.