Do potential side effects mean vaccines should be avoided in people with psoriasis?
Vaccines offer protection from serious, preventable illness. Most children and adults can reap these benefits with very little health risk by following the recommended vaccination schedule for their age. The Centers for Disease Control and Prevention creates these schedules.
If you have psoriasis, you may need to work more closely with your health care provider. Vaccinations can be more complicated for people with this condition. For example, for some people with psoriasis, injected vaccines may increase the risk of a psoriasis flare at the injection site. This reaction is called Koebner phenomenon. It can occur when your immune system rushes in to heal the wound caused by the injection. With Koebner phenomenon, any skin injury can cause psoriasis patches to form at the site of the injury. Examples of injuries that can lead to this reaction are sunburn, scratches and surgical wounds.
Also, the nasal spray flu vaccine and some other live vaccines may not be safe if you're taking or scheduled to take drugs that alter or weaken your immune system. Live vaccines are made with a small amount of a weakened, also called attenuated, virus. Like all vaccines, live vaccines cause your immune system make antibodies that help your body fight off infection. However, when your immune system is suppressed, exposure to a live virus may cause the infection that the vaccine was made to prevent.
Your health care provider can help you consider the risk of serious infection from live-virus exposure and the risk of Koebner phenomenon from a skin injection. The right choice for you in such cases will depend on your current health and medical treatments.
Experts agree that the potentially lifesaving benefits of vaccinations significantly outweigh the risks in people who have psoriasis. Certain psoriasis medications are known to increase the risk of dangerous infections. These include methotrexate, cyclosporine and biologics.
Show References
- Psoriasis. AskMayoExpert. Mayo Clinic; 2021.
- Causes and triggers. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/causes. Accessed Dec. 24, 2018.
- Lopez A, et al. Vaccination recommendations for the adult immunosuppressed patient: A systematic review and comprehensive field synopsis. Journal of Autoimmunity. 2017; doi:10.1016/j.jaut.2017.03.011.
- Shi CR, et al. Widespread psoriasis flare following influenza vaccination. Vaccine. 2017; doi:10.1016/j.vaccine.2017.06.067.
- Live attenuated influenza vaccine [LAIV] (the nasal spray flu vaccine). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/prevent/nasalspray.htm. Accessed Dec. 6, 2022.
- Menter A, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. Journal of the American Academy of Dermatology. 2018; doi:10.1016/j.jaad.2018.11.057.
- Feldman SR. Treatment of psoriasis in adults. https://www.uptodate.com/contents/search. Accessed Dec. 7, 2022.
Original article: https://www.mayoclinic.org/diseases-conditions/psoriasis/expert-answers/what-are-the-risks-of-vaccinations-for-people-living-with-psoriasis/faq-20347590