Do different platforms of coronavirus vaccines have different impacts on psoriasis flares?

This study evaluated the impacts on psoriasis flares of 3 vaccine platforms: inactivated, viral vector and mRNA. Respectively, 198 and 96 psoriasis patients with and without COVID‐19 vaccination during the study period. Group comparison revealed no increased risk of psoriasis flaring after COVID‐19 vaccination. The vaccinated group received 425 doses of vaccine (140 inactivated, 230 viral vector and 55 mRNA). Patients' self‐reported symptoms included all three platforms causing psoriasis flare, but the highest was among patients administered with mRNA vaccines. Most flares were mild to moderate, and most patients (89.8%) managed their flare‐up lesions without rescue therapy. In conclusion, our study showed that the rate of psoriasis flare was not significantly different between vaccinated and unvaccinated groups. Factors that might explain psoriasis flare include vaccine‐related psychological stress and side effects from vaccination. Different platforms of corona vaccines seemed to have different impact of psoriasis flares. Based on our results and the recommendations of several consensus guidelines, the benefits of COVID vaccinations outweigh the risks to patients with psoriasis. Patients with psoriasis should receive a COVID vaccine as soon as one is available.

[1]  C. Demirdover.  COVID-19-vaccines , 2021, Reactions Weekly.

[2]  L. Chew,et al.  Post-mRNA vaccine flares in autoimmune inflammatory rheumatic diseases: Results from the COronavirus National Vaccine registry for ImmuNe diseases SINGapore (CONVIN-SING) , 2022, Journal of Autoimmunity.

[3]  K. Vedhara,et al.  Barriers and facilitators to vaccination uptake against COVID-19, influenza, and pneumococcal pneumonia in immunosuppressed adults with immune-mediated inflammatory diseases: A qualitative interview study during the COVID-19 pandemic , 2022, PloS one.

[4]  Chun-Bing Chen,et al.  New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review , 2022, American Journal of Clinical Dermatology.

[5]  J. Levi,et al.  Efficacy of Approved Versus Unapproved Vaccines for Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Randomized Blinded Clinical Trials , 2022, Open forum infectious diseases.

[6]  D. McDonnell,et al.  Estrogen receptor signaling in the immune system. , 2022, Endocrine reviews.

[7]  Philip R. O. Payne,et al.  Estrogen hormone is an essential sex factor inhibiting inflammation and immune response in COVID-19 , 2022, Scientific Reports.

[8]  K. Soonklang,et al.  Safety and Immunogenicity of the BBIBP-CorV Vaccine in Adolescents Aged 12 to 17 Years in the Thai Population: An Immunobridging Study , 2022, Vaccines.

[9]  P. Mease,et al.  COVID-19 Update for the GRAPPA 2021 Annual Meeting: Focus on COVID-19 Vaccination. , 2022, The Journal of rheumatology.

[10]  Manfred S. Green,et al.  Gender Differences in Adverse Events Following the Pfizer-BioNTech COVID-19 Vaccine , 2022, Vaccines.

[11]  K. Krasagakis,et al.  Psoriasis flare‐up after AZD1222 and BNT162b2 COVID‐19 mRNA vaccines: report of twelve cases from a single centre , 2022, Journal of the European Academy of Dermatology and Venereology : JEADV.

[12]  T. Tsai,et al.  Exacerbation of Psoriasis Following COVID-19 Vaccination: Report From a Single Center , 2021, Frontiers in Medicine.

[13]  M. Lebwohl,et al.  New onset and exacerbation of psoriasis after COVID-19 vaccination , 2021, JAAD Case Reports.

[14]  Shirin Heidari,et al.  A Systematic Review of the Sex and Gender Reporting in COVID-19 Clinical Trials , 2021, Vaccines.

[15]  Philip R. O. Payne,et al.  Estrogen hormone is an essential sex factor inhibiting inflammation and immune response in COVID-19 , 2021, Research square.

[16]  G. Fabbrocini,et al.  Reply to “Psoriasis exacerbation after COVID‐19 vaccination: report of 14 cases from a single centre” by Sotiriou E et al. , 2021, Journal of the European Academy of Dermatology and Venereology : JEADV.

[17]  C. Chien,et al.  Sex Differences in Adverse Reactions to an Inactivated SARS-CoV-2 Vaccine Among Medical Staff in China , 2021, Frontiers in Medicine.

[18]  K. Choe,et al.  Reactogenicity after the first and second doses of BNT162b2 mRNA coronavirus disease vaccine: a single-center study , 2021, Clinical and experimental vaccine research.

[19]  C. Papadopoulou,et al.  COVID-19 and autoinflammatory diseases: prevalence and outcomes of infection and early experience of vaccination in patients on biologics , 2021, Rheumatology advances in practice.

[20]  Ecem Bostan,et al.  Exacerbation of plaque psoriasis after inactivated and BNT162b2 mRNA COVID‐19 vaccines: A report of two cases , 2021, Dermatologic therapy.

[21]  A. Lallas,et al.  Psoriasis exacerbation after COVID‐19 vaccination: a report of 14 cases from a single centre , 2021, Journal of the European Academy of Dermatology and Venereology : JEADV.

[22]  D. Segev,et al.  Disease Flare and Reactogenicity in Patients With Rheumatic and Musculoskeletal Diseases Following Two‐Dose SARS–CoV‐2 Messenger RNA Vaccination , 2021, Arthritis & rheumatology.

[23]  L. Ferris,et al.  COVID-19 vaccine safety and efficacy in patients with immune-mediated inflammatory disease: Review of available evidence , 2021, Journal of the American Academy of Dermatology.

[24]  Cui Xiaoni,et al.  Emergency use of COVID-19 vaccines recommended by the World Health Organization (WHO) as of June 2021. , 2021, Drug discoveries & therapeutics.

[25]  F. Iannone,et al.  Preliminary Data on Post Market Safety Profiles of COVID 19 Vaccines in Rheumatic Diseases: Assessments on Various Vaccines in Use, Different Rheumatic Disease Subtypes, and Immunosuppressive Therapies: A Two-Centers Study , 2021, Vaccines.

[26]  L. Mandl,et al.  Systemic rheumatic disease flares after SARS-CoV-2 vaccination among rheumatology outpatients in New York City , 2021, Annals of the Rheumatic Diseases.

[27]  A. Lallas,et al.  COVID‐19 vaccination intention among patients with psoriasis compared with immunosuppressed patients with other skin diseases and factors influencing their decision , 2021, The British journal of dermatology.

[28]  M. Jit,et al.  Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment , 2021, The Lancet.

[29]  M. Lebwohl,et al.  National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2—Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments , 2021, Journal of the American Academy of Dermatology.

[30]  Nguyen H. Tran,et al.  T cell and antibody responses induced by a single dose of ChAdOx1 nCoV-19 (AZD1222) vaccine in a phase 1/2 clinical trial , 2020, Nature Medicine.

[31]  E. Stratman,et al.  Psoriasis Flares Following Systemic Glucocorticoid Exposure in Patients With a History of Psoriasis. , 2020, JAMA dermatology.

[32]  A. Conesa,et al.  Transcriptional Differences for COVID-19 Disease Map Genes between Males and Females Indicate a Different Basal Immunophenotype Relevant to the Disease , 2020, bioRxiv.

[33]  C. Foresta,et al.  Gender susceptibility to COVID-19: a review of the putative role of sex hormones and X chromosome , 2020, Journal of Endocrinological Investigation.

[34]  M. Lebwohl,et al.  National Psoriasis Foundation COVID-19 Task Force Guidance for Management of Psoriatic Disease During the Pandemic: Version 1 , 2020, Journal of the American Academy of Dermatology.

[35]  M. Komine,et al.  Generalized exacerbation of psoriasis vulgaris induced by pneumococcal polysaccharide vaccine , 2019, The Journal of dermatology.

[36]  M. G. Gubbels Bupp,et al.  Androgen-Induced Immunosuppression , 2018, Front. Immunol..

[37]  O. Ozbagcivan,et al.  Possible Triggering Effect of Influenza Vaccination on Psoriasis , 2015, Journal of immunology research.

[38]  T. Jorgensen,et al.  Suppressive effects of androgens on the immune system. , 2015, Cellular immunology.

[39]  V. Macias,et al.  Psoriasis triggered by tetanus-diphtheria vaccination , 2013, Cutaneous and ocular toxicology.

[40]  S. Ansar Ahmed,et al.  Estrogen up-regulates inducible nitric oxide synthase, nitric oxide, and cyclooxygenase-2 in splenocytes activated with T cell stimulants: role of interferon-gamma. , 2006, Endocrinology.

[41]  C. Schreck,et al.  Characterization of an androgen receptor in salmonid lymphocytes: possible link to androgen-induced immunosuppression. , 1995, General and comparative endocrinology.

[42]  W. Raaschou-Nielsen.  Psoriasis vaccinalis; report of two cases, one following B.C.G. vaccination and one following vaccination against influenza. , 1955, Acta dermato-venereologica.