Dermatology Patients on Biologics and Certain Other Systemic Therapies Should Receive a 'Booster' mRNA COVID-19 Vaccine Dose

TAKE-HOME MESSAGE

• The Advisory Committee on Immunization Practices recommends a 3rd dose of the mRNA COVID-19 vaccine for certain immunocompromised individuals ≥28 days after completion of their 2-dose vaccine series. The authors review the current literature and evaluated its application to dermatology patients. Patients with psoriasis and psoriatic arthritis treated with glucocorticoids, mycophenolate mofetil, methotrexate, and anti-CD20 monoclonal antibodies, have reduced rates of seroconversion. A reduction in seroconversion was not seen in patients taking IL-17 and TNF inhibitors. A third dose lead to seroconversion in 33% to 50% of patients who had no detectable antibody response to the initial vaccine series.

• Patients taking high-dose systemic glucocorticoids, oral immunosuppressants, or B-cell depletion therapies require an additional dose of the mRNA COVID-19 vaccine. This is not necessary for patients taking IL-17, TNF, IL-12/23, IL-23, and IL-4/13 inhibitors.

–  Katherine M. Stiff, MD

Abstract

On August 12th, 2021, the FDA expanded the emergency use authorization of both mRNA COVID-19 vaccines "to allow for the use of an additional dose in certain immunocompromised individuals.1" This announcement may leave dermatologists wondering whether certain patients should receive a 3rd dose of the mRNA COVID-19 vaccine. Herein, we will summarize the data supporting the FDA/ACIP expansion of vaccine authorization and then apply this data to dermatology practice.

Journal of the American Academy of Dermatology

Dermatology Patients on Biologics and Certain Other Systemic Therapies Should Receive a 'Booster' mRNA COVID-19 Vaccine Dose: A Critical Appraisal of Recent FDA and ACIP Recommendations

J Am Acad Dermatol 2021 Aug 23;[EPub Ahead of Print], RA Waldman, JM Grant-Kels 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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