35304 Safety and efficacy of COVID-19 vaccination in psoriasis patients

Abstract

Background: To date there are 3 FDA-authorized COVID-19 vaccines: BNT162b2, mRNA-1273, and Ad26.COV.2.S. The clinical trials behind these approvals did not test vaccines in immunocompromised patients nor stratify patients with various comorbidities. Therefore, the aim was to compare adverse outcomes in vaccinated patients with and without psoriasis. Design: A retrospective analysis was conducted using TriNetX, a real-time multicenter database, from December 2020-May 2021. A 1:1 matched propensity score analysis was conducted, adjusting for comorbidities and demographics, to generate adjusted risk ratios (aRRs) with 95% CI. Outcomes included breakthrough COVID infections, 1-day anaphylaxis, 30- and 60-day follow-up for all-cause hospitalization, and FDA-defined adverse events of special interest (AESI). Subgroup analysis was also conducted for those with a 1-year history of methotrexate or TNF inhibitor use. Summary: From the 904,952 patients who received a COVID-19 vaccine, 1.1% had psoriasis. After matching, there were no differences between cohorts for 1-day anaphylaxis or for 30- and 60-day all-cause hospitalization or AESIs. However, vaccinated psoriatic patients were at a higher risk for new COVID infection in 30-day (RR = 2.67 [1.6-4.5]) and 60-day follow up (RR = 2.09 [1.4-3.2]). Subgroup analysis revealed no difference in any assessed outcomes for those with a 1-year history of methotrexate or TNF inhibitors. Conclusion: These results show that the COVID-19 vaccine is safe and effective for psoriatic patients. Although breakthrough infection had a higher risk in the psoriatic cohort, the overall prevalence was still <0.6%. Further research is warranted to study the impacts of vaccination on psoriatic patients, especially in more severe forms.