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The existing evidence and recommendations for use of vaccinations, including the SARS-CoV-2 vaccinations, on dermatologic patients receiving immune therapies is reviewed. The estimated risk of non-viral or inactivated SARS-CoV-2 vaccinations to these patients is low. Risk-to-benefit ratio may favor immunization if there is a significant risk of viral infection. Patients on systemic corticosteroids, methotrexate, and JAK inhibitors have the greatest risk of reduced antibody production from the vaccination. TNF-alpha biologics, ustekinumab, and rituximab may also decrease antibody titers. Checking post-vaccination titers and providing additional vaccinations if necessary may boost the level of protective antibodies, but this is not yet studied in with the SARS-CoV-2 vaccines.
Based on existing evidence, the SARS-CoV-2 vaccines currently available and in development are expected to be safe for patients with dermatologic conditions on immune therapies, although there may be variability in vaccine efficacy depending on the degree of immunosuppression and type of vaccine given.
– Margaret Hammond, MD
This abstract is available on the publisher's site.
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. A review of the literature was conducted by a multidisciplinary committee to provide guidance on the safety and efficacy of SARS-CoV-2 vaccination for dermatologists and other clinicians when prescribing immunotherapeutics. The vaccine platforms being used to develop SARS-CoV-2 vaccines are expected to be safe and potentially effective for dermatology patients on immunotherapeutics. Current guidelines for vaccination of an immunocompromised host remain appropriate when considering future administration of SARS-CoV-2 vaccine.