Psoriasis is an autoimmune condition that causes chronic skin inflammation. Psoriasis, and the drugs people use to treat it, may cause some issues for people receiving certain vaccines.

Psoriasis is an autoimmune condition that affects over 8 million people in the United States. It causes red, purple, or grayish patches to develop on a person’s skin. These patches can become covered in silvery scales.

People with psoriasis can experience an intense itching or burning sensation. Symptoms come in flare-ups, which can last different lengths of time.

In this article, we look at whether vaccines are safe for people with psoriasis and if vaccines can cause psoriasis. We also review common vaccines and their potential side effects for people with psoriasis.

A person with psoriasis who got the vaccine.Share on Pinterest
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Psoriasis flare-ups occur because certain triggers cause the immune system to react when it shouldn’t. During a flare-up, the immune system can mistakenly attack healthy cells as though they are harmful pathogens.

A person with psoriasis is not necessarily immunocompromised. Healthcare professionals may prescribe immunosuppressants to treat psoriasis.

Immunosuppressant drugs reduce the strength of a person’s immune system, which can cause a person to become immunocompromised.

These immunosuppressant drugs also can affect the way a person’s body responds to particular vaccines.

If a person is unsure if they are taking immunosuppressant drugs, they should speak with a healthcare professional.

Live vaccines

Live vaccines use viral or bacterial strains that can replicate in a person’s body. They trigger a person’s immune system to respond to them, causing the person to produce antibodies for that particular pathogen.

Because live vaccines are similar to natural infection, they can create a long-lasting immune response to protect a person against that infection.

Due to the fact that they weaken the immune system, however, immunosuppressant drugs can cause live vaccines to replicate in an uncontrolled manner in immunocompromised individuals. This can place a person at greater risk of viral transmission and active infection with the virus that they are being vaccinated against.

This is why medical professionals suggest that a person avoid having a live vaccine while taking immunosuppressant drugs.

Non-live vaccines

Non-live vaccines, sometimes called inactivated vaccines, use a dead version of the pathogen that causes a disease. Despite the pathogen being dead, the immune system is still able to build an immune response to help it fight live versions of the pathogen in the future.

These vaccines often provide less immunity than live vaccines. This means a person may require other doses later on, which many call booster shots.

Medical professionals consider non-live vaccines to be safer for immunocompromised people.

If a person is using systemic agents such as cyclosporine and methotrexate to treat their psoriasis, or systemic corticosteroids, they may wish to discontinue these treatments before having their non-live vaccine.

However, if a person is treating their psoriasis with biological agents, they may be able to continue their treatment safely while having their vaccine. This is because research has not associated biological agents with lower antibody responses in people.

There is not a lot of research on whether vaccines can cause psoriasis to develop in people who previously did not have the disease.

One 2015 study found that H1N1 influenza vaccines given from 2009-2010 had the potential to trigger the development of psoriasis.

However, the study also stated that this was very rare. Confirming whether this relationship exists would require larger studies with greater controls.

There is evidence that some vaccines may trigger a flare-up in people who already have psoriasis.

One 2019 review found several studies showed that there is an association between the influenza vaccination and the worsening of psoriasis symptoms.

One reason for a flare-up may be the Koebner phenomenon. This occurs when new skin lesions appear on previously unaffected skin at the site of a needle entry.

People with psoriasis who are using immunosuppressant medications are more at risk of developing illnesses that viruses and bacteria cause. This is because the medications weaken their immune system.

Therefore, people with psoriasis should consider receiving vaccines to reduce their risk of infection.

Below are some common vaccines, their possible side effects, and any possible effects they may have on people with psoriasis:

Hepatitis B

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV).

The vaccine for hepatitis B comes in the form of three injections. While a person can receive the first injection at any age, the general recommendation is that babies receive it soon after birth.

The second shot should then take place at least 1 month after the first, with the third shot at least 8 weeks after the second. Infants should not receive the third dose before they reach 24 weeks old.

While most people tolerate the hepatitis B vaccine well there are some possible side effects.

According to the Centers for Disease Control and Prevention (CDC) the most common side effects are fever and soreness at the site of the injection. Other side effects include swelling, hard skin, and redness around the injection site.

In some rare instances, this vaccine can cause a serious allergic reaction called anaphylaxis.

Because the hepatitis B vaccine is a non-live vaccine, medical professionals deem it safer for a person with psoriasis.

However, if the person is using certain systemic agents to treat psoriasis, such as cyclosporine and methotrexate, they may wish to stop their treatment before their vaccine or switch to a biologic treatment.

Diphtheria and tetanus

Diphtheria is a contagious disease of the nose and throat. Diphtheria is extremely rare in the United States. However, it can be fatal if someone does not receive proper treatment.

Tetanus, also known as lockjaw, is a bacterial infection that affects the brain and nervous system. It can cause muscle stiffness and spasms, as well as breathing difficulties, and can also be fatal.

Though these two conditions are not connected, people often receive a vaccine for both at the same time.

The CDC recommend that all babies, children, preteens, teens, and adults get the diphtheria and tetanus vaccine.

Side effects are usually mild and tend to go away on their own. Common side effects include:

One study suggested that the diphtheria vaccine may be able to trigger psoriasis. However, the study only included one person, and it stated that it may be the first reported case of psoriasis triggered by the vaccine.

More research is necessary to decide if there is a clear link between the diphtheria and tetanus vaccine and psoriasis.

Influenza

A viral infection causes the respiratory illness influenza. It is commonly known as the flu and is highly contagious.

Symptoms of influenza include:

  • high temperature
  • a stuffy or runny nose
  • cold sweats
  • shivers
  • muscular aches and pains

People with psoriasis who are using immunosuppressive medications are at greater risk of developing influenza.

There are a number of influenza vaccines, which people commonly call flu shots. These vaccines change over time and protect against the specific influenza viruses that may be most common in the upcoming season.

Common side effects of the flu shot include:

  • soreness, redness, and swelling at the injection site
  • headaches
  • fever
  • nausea
  • muscle aches
  • fatigue

Some evidence suggests that these vaccines could trigger psoriasis to develop in rare cases. However, more research is necessary to see if there is a link between the vaccine and psoriasis.

One study suggests that the influenza vaccine may also cause flare-ups in people with chronic psoriasis. However, the study also states that it is an uncommon triggering factor.

The study said the low incidence of flare-ups after influenza vaccination should not lead to a change in the immunization practice. The vaccine is important, especially for people with psoriasis that are taking immunosuppressive and biologic therapies.

Psoriasis is a common chronic inflammatory skin disease. It causes red, purple, or grayish patches to develop on a person’s skin. The skin may also develop a scaly, silvery appearance.

Psoriasis may also cause an intense itching or burning sensation. These symptoms occur in flare-ups between periods of remission.

People with psoriasis may take immunosuppressant drugs to treat their condition. These drugs reduce the strength of a person’s immune system, and may cause them to be immunocompromised.

This means that they may be vulnerable to infection if they receive some live vaccines.

In rare cases, it appears possible that vaccines may cause a person’s psoriasis to flare up. More research is necessary to determine whether vaccines can trigger psoriasis in people who previously did not have the disease.