NPF Releases COVID-19 Booster Guidance

The National Psoriasis Foundation (NPF) COVID-19 Task Force has updated its guidance statements after the Centers for Disease Control and Prevention (CDC) released new information for COVID-19 vaccines for moderately to severely immunocompromised patients.¹ 

The CDC has recommended patients who are moderately to severely immunocompromised receive an additional dose of the mRNA COVID-19 vaccine as they may be at an increased risk of infection due to their increased risk of serious, prolonged illness.²

The NPF COVID-19 Task Force changed their guidance statements to provide clarity for psoriasis patients¹:

• People with psoriatic disease treated with immunosuppressive or immune-modulating therapies that affect the immune system in a manner that may make a patient more susceptible to infection are eligible for a third dose “booster” mRNA COVID-19 vaccine, per CDC recommendations.
• This booster vaccine should be administered at least 28 days following the two-dose regimen of the same vaccine, and only to patients ages 12 and older (Pfizer-BioNTech vaccine) or in patients ages 18 and older (Moderna vaccine and Pfizer-BioNTech vaccine). The CDC has not issued recommendations for boosters in patients who received the one dose Ad26.COV2.S vaccine manufactured by Johnson & Johnson.

As of now, there is no information on whether a third dose of an mRNA vaccine will result in greater clinically important benefits for patients who are being treated with an immunosuppressive or immune-modulating medicines. The statements outline specific circumstances where patients with psoriatic disease may be more likely to benefit, such as¹:

• People aged 50 or older. 
• People taking abatacept (Orencia; Bristol Myers Squibb), cyclosporine (Cequa; Novartis), leflunomide (Arava; Sanofi), glucocorticoids (e.g., prednisone), methotrexate, or tofacitinib (Xeljanz, Xeljanz XR; Pfizer). 
• People who received their second dose of an mRNA vaccine over 6 months ago.
• People with comorbidities known to increase the risk of severe COVID-19, such as being overweight, being a current or former smoker, or having diabetes, cardiovascular disease, chronic lung, liver, or kidney disease.
• Patients who are being treated with methotrexate with well-controlled psoriatic disease, may, in consultation with their prescriber, consider holding the medication for 2 weeks after receiving a third mRNA vaccine to potentially improve vaccine response, according to the press release.

“The COVID-19 vaccines are safe and effective. We urge those not yet vaccinated to get vaccinated as soon as possible. Those already vaccinated have a dramatically reduced risk of developing severe COVID-19 and now have additional options for a booster vaccine that may add additional protection from this disabling and deadly virus,” said Joel M. Gelfand, MD, MSCE, FAAD, professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine and co-chair of the NPF COVID-19 Task Force, in Philadelphia, Pennsylvania.

The NPF COVID-19 Task Force was launched in May 2020, to help identify high-priority needs of the psoriatic disease community and to serve as a resource for the organization to advise decisions. It includes physicians with expertise in dermatology, rheumatology, infectious disease, and critical care, in addition to fellows and NPF team members, states the press release.

The NPF plans to continue monitoring the COVID-19 situations and the emerging variants and the task force does recommend that patients in the community talk to their health care provider about a third booster and the use of systemic therapies during the pandemic.

Reference:

1. NPF task force issues new guidance statements addressing covid-19 vaccine boosters. Published August 25, 2021. Accessed September 8, 2021. https://www.psoriasis.org/covid-19-vaccine-booster-statement/

2. CDC. COVID-19 Vaccination. Centers for Disease Control and Prevention. Published September 2, 2021. Accessed September 8, 2021. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html