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What People With Psoriasis Should Know About Getting a Second COVID-19 Booster Shot

Posted on July 21, 2022
Medically reviewed by
Robert Hurd, M.D.
Article written by
Manuel Penton, M.D.

  • The Centers for Disease Control and Prevention (CDC) has approved a second COVID-19 booster shot of the Moderna or Pfizer messenger RNA (mRNA) vaccines for people over 50 years old and those who are immunocompromised.
  • Recent studies found that most people who were immunocompromised had a strong immune response to mRNA vaccines for COVID-19.
  • The National Psoriasis Foundation has identified several groups of people who would be most likely to benefit from a second booster shot to protect against COVID-19.

The CDC and U.S. Food and Drug Administration (FDA) have authorized and recommended a second COVID-19 booster shot for people 50 and over and those with immunocompromising conditions.

The National Psoriasis Foundation (NPF) recommends that people with psoriasis share the decision-making with their doctors about whether to get a second booster shot against COVID-19. The organization identified several groups who are more likely to benefit from a second booster shot.

The New Recommendations

Some important details about these recommendations include the following:

  • This booster is for people who received their first booster at least four months ago.
  • This fourth shot would be of either the Moderna or Pfizer vaccines, not the Johnson & Johnson vaccine.
  • Even if you were previously vaccinated with the Johnson & Johnson vaccine, it is now recommended that this next dose be a Moderna or Pfizer vaccine only.
  • For those who are immunocompromised and received a three-dose primary vaccination followed by an initial booster, this additional booster counts as a fifth shot.

How Booster Shots Can Protect People With Psoriasis

If you already had your first booster shot, you may be wondering what psoriasis experts say about whether additional boosters are effective for people with psoriasis. The NPF urges individuals with psoriatic disease to speak with their providers about whether to get a second booster shot, and if so, how to time the inoculations around psoriasis therapies.

“It is recommended that patients who are to receive an mRNA-based COVID-19 booster vaccine continue their biologic or oral therapies for psoriasis and/or psoriatic arthritis in most cases,” the NPF notes.

The NPF guidelines go on to say, “Patients who are taking methotrexate with well-controlled psoriatic disease may, in consultation with their prescriber, consider holding it for two weeks after receiving [a booster] vaccine in order to potentially improve vaccine response.”

In addition, the NPF suggests certain groups of people with psoriatic disease are more likely to benefit from a second booster against COVID-19:

  • People with additional conditions that boost the risk of severe COVID-19, such as those who smoke, are overweight, or have diabetes or cardiovascular disease, as well as those who have chronic lung, liver, or kidney disease
  • Individuals over age 60
  • People taking medications such as abatacept (Orencia), leflunomide (Arava), cyclosporine (Neoral), glucocorticoids (such as prednisone), methotrexate, tofacitinib (Xeljanz), or upadacitinib (Rinvoq)
  • Individuals who face a higher risk of COVID-19 transmission and exposure because of where they work or live, such as those working with unvaccinated children or immunocompromised elderly people

The CDC’s list of underlying medical conditions doesn’t explicitly mention psoriasis as a condition that may increase the risk of severe illness from COVID-19. The list of underlying medical conditions includes, for example, chronic lung disease, diabetes, heart conditions, obesity, smoking or smoking history, and HIV infection.

However, as noted by the NPF, certain factors can make people with psoriasis more likely to benefit from COVID-19 booster shots. Talk with your doctor if you have questions about your eligibility for an additional COVID-19 vaccine dose.

“Just got my second booster today,” said one MyPsoriasisTeam member. Another said, “Received my Pfizer booster a week ago. Feeling pretty darn good!”

Why Booster Shots Matter

Research indicates that antibody levels are likely to decrease over time, so getting booster doses at recommended intervals is necessary — even for vaccinated people who made antibodies after their initial shots.

Simply making antibodies does not always translate to complete immunity from COVID-19 infection. The findings from recent studies, however, are promising. In one study of immunocompromised people with cancer, researchers tested levels of antibodies (proteins made by the immune system to help destroy a target). In this case, the antibodies were to SARS-CoV-2 (the virus that causes COVID-19), made in response to the Moderna COVID-19 vaccine.

On average, antibodies against the coronavirus were identified after the second vaccine dose in about 90 percent of the study’s 515 participants. These results are considered a good sign that vaccines using mRNA — which include those by Moderna and Pfizer — for COVID-19 can trigger strong responses, even in people with compromised immune systems. It’s evidence that vaccines can protect people at higher risk of severe infections.

According to the CDC, getting vaccinated is still the best way to protect yourself and slow the spread of the virus. If you are unvaccinated due to immunodeficiency, an autoimmune disease, or cancer treatment or because you are an organ transplant recipient, this new research should give you confidence to speak with your health care provider about when COVID-19 vaccination would be right for you.

Find Your Team

On MyPsoriasisTeam, the social support network for people with psoriatic disease and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand.

Are you considering getting a second booster shot? Have you discussed any concerns with your health care provider? Share your insights in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Robert Hurd, M.D. is a professor of endocrinology and health care ethics at Xavier University. Review provided by VeriMed Healthcare Network. Learn more about him here.
Manuel Penton, M.D. is a medical editor at MyHealthTeam. Learn more about him here.

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