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Vaccination recommendations for patients with psoriatic disease receiving oral and biologic therapies

Mar 21, 2024
Learning objective: After reading this article, learners will be able to cite a new clinical development in psoriatic disease.

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Individuals with moderate-to-severe psoriasis and/or psoriatic arthritis are at an increased risk of infection. However, guidance is required to understand how to best manage vaccination alongside systemic psoriasis treatment. 

Here, we summarize recommendations by Chat et al. published in Journal of the American Academy of Dermatology, on the use of biologics and oral treatments in patients with psoriatic disease receiving vaccinations. 


  • A literature review of articles published in PubMed from 1950–2022 that included the terms ‘vaccine’ or ‘vaccination’ and each systemic therapy approved for psoriasis or psoriatic arthritis was conducted and used to develop 22 consensus statements through a modified Delphi process. 

  • Overall, 30 members of the National Psoriasis Foundation and COVID-19 Task Force voted to report their level of agreement with each statement. 

  • Where there was insufficient data, recommendations were developed using expert opinion. 

Key findings1 

  • Overall, 22 consensus statements were agreed for oral (Figure 1) and biologic (Figure 2) therapies. 

  • In general, recommendations state that: 

    • non-live vaccines can be given without disruption to oral or biologic therapy, apart from methotrexate; and 

    • oral or biologic therapy should be discontinued before and after live vaccination. 

  • Recommendations could not be given for the use of vaccines with phototherapy due to a lack of available clinical data. 

Figure 1. Vaccine recommendations for patients receiving oral therapies*  

*Data from Chat, et al.1 Created with 


Figure 2. Vaccine recommendations for patients receiving biologic therapies* 

IL, interleukin; TNF, tumor necrosis factor. 
*Data from Chat, et al.1 Created with 


Key learnings 

  • Based on the reviewed evidence, non-live vaccines are well tolerated in patients with psoriatic disease and can often be given alongside oral or biologic therapy. 

  • For patients receiving live vaccines, most oral and biologic therapies should be temporarily discontinued before and after vaccination 

  • Where possible, live vaccines should be administered before starting systemic therapy for psoriatic disease 

  • These recommendations have been created to guide clinical practice but may not apply to every patient. The decision to implement them should be based on a risk-benefit analysis considering psoriatic disease activity and comorbidities. 

  1. 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. Online ahead of print. DOI: 10.1016/j.jaad.2023.12.070 


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