Vaccination Recommendations for Patients Receiving Antipsoriatic Systemic Therapies

According to a study published in the Journal of the American Academy of Dermatology, temporary interruption of antipsoriatic oral and biologic therapies is recommended before and after administering live vaccines in most cases.

Researchers aimed to evaluate the literature on vaccine efficacy and safety, using a modified Delphi process to generate 22 consensus-based recommendations for adults receiving systemic therapies for psoriasis and/or psoriatic arthritis who are also receiving nonlive or live vaccines.

Key recommendations include:

• Nonlive vaccines: Most oral and biologic therapies can be continued without modification. However, there is a consideration to interrupt methotrexate for nonlive vaccines.
   
• Live vaccines: Discontinuation of most oral and biologic medications is advised before and after the administration of live vaccines. Specific guidance includes discontinuing most biologic therapies, except abatacept, for 2 to 3 half-lives before live vaccine administration and deferring the next dose for 2 to 4 weeks after live vaccination.

For nonlive vaccines, the interruption of antipsoriatic oral and biologic therapies is generally unnecessary. However, temporary interruption of these therapies is recommended before and after administering live vaccines in most cases. This approach aims to balance the need for vaccination with the management of psoriatic disease, ensuring patient safety and treatment efficacy.

Reference
Chat VS, Ellebrecht CT, Kingston P, et al. Vaccination recommendations for adults receiving biologics and oral therapies for psoriasis and psoriatic arthritis: Delphi consensus from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2024;90(6):1170-1181. doi:10.1016/j.jaad.2023.12.070