Vaccines and psoriasis are closely related. Some medications for psoriasis can increase the risk of certain diseases. These diseases can be prevented with vaccinations. However, protective vaccinations and psoriasis are often associated with side effects. Patients with psoriasis therefore need to obtain particularly detailed information on this topic.
What is a vaccine?
A vaccine is a targeted delivery of pathogens to the body. This trains the immune system. After the vaccination, it can quickly recognize pathogens such as viruses or bacteria and combat them in a targeted manner.
During vaccination, certain molecules of the pathogen are introduced into the body. These molecules are called antigens and trigger an immune response. By injecting the antigens, the immune system learns to recognize hostile intruders. It quickly produces antibodies and stores them for the future. If an infection now occurs, the immune system immediately fights the attackers. The pathogens cannot spread in the body and the disease does not break out.
Different types of vaccinations
Vaccines must be administered in such a way that they trigger an immune response without causing the person to become seriously ill. To achieve this, there are different types of vaccines. The most important distinction is between live vaccines and inactivated vaccines. This distinction is also important for autoimmune diseases. For example, special precautions apply when combining vaccinations and psoriasis.
Vaccination with live vaccines
In vaccinations with live vaccines, an attenuated form of the pathogen is introduced into the body. Since the pathogen is weakened, it does not cause any real disease. However, the dose is chosen in such a way that the body’s defense system reacts anyway. In this way, antibodies are produced and the immune system is trained for a possible infection.
Advantages of live vaccinations
As living pathogens enter the body with this vaccination method, the immune system is prepared for a possible disease in the best possible way. Usually, only one or two doses of the vaccine are sufficient to guarantee lifelong immunity.
Since they contain live pathogens, attenuated live vaccines are not administered to persons with weakened immune systems. For example, people undergoing chemotherapy are not vaccinated with live vaccines.
It is also important that live vaccines are always be kept refrigerated. Otherwise, there is a risk that the weakened pathogen will die. The vaccination would then be ineffective.
Typical live vaccines are:
- Influenza (as a nasal spray for children)
Vaccination with inactivated vaccines
For inactivated vaccines, we work with dead or inactivated pathogens. The specific viruses or bacteria are killed by heat or chemicals. The then dead cells are administered as a vaccination. Even if the pathogen is dead, the immune system can still learn from its antigens.
A great advantage of this method is the risk-free storage of the vaccines. Since the pathogens are freeze-dried, there is no risk of attenuating the effect. On the other hand, there is also no risk that the virus or bacterium will be “activated” again and thus cause serious diseases.
Since the pathogen is dead, vaccination with inactivated vaccines is an attenuated representation of reality. Often several doses of the vaccination are necessary to train the body sufficiently against the pathogen.
Typical inactivated vaccines are
- Hepatitis A
Which vaccinations are recommended?
Different vaccinations are recommended depending on age and sex.
In order to find the best and most sensible protection for the individual, it is advisable to consult a vaccination specialist. Especially in the case of autoimmune diseases such as psoriasis, a doctor should be consulted before vaccination.
The most important vaccinations
Tetanus is caused by a bacterium in the soil. The infection can be caused by even a small injury. The disease often progresses dramatically and can be fatal. The basic immunization is carried out as a child, after which regular booster sessions are necessary.
This disease is triggered by a bacterium that is transmitted by droplet infection. Severe paralysis is the result. This is a life-threatening infection. The basic immunization is carried out as a child, after which regular boosters are necessary.
Polio (poliomyelitis, polio)
This disease is caused by viruses. Although the disease mainly affects young children, polio can also affect adults. Therefore, basic immunization should be carried out in childhood and refreshed when traveling to high-risk areas.
Mumps is a viral disease spread by droplet infection. High fever and the swollen glands typical of the disease are the result. If the basic immunization is carried out as a child, there is lifelong protection.
This highly contagious infectious disease leads to high fever and a general weakening of the body. Typical are the red spots all over the body. Measles is caused by viruses. A basic immunization as a child provides lifelong protection.
The disease is caused by viruses. It is particularly high-risk for pregnant women and women who want to get pregnant. If the vaccination was not administered as a child, it can be done as an adult.
If you plan on traveling, it is advised that you get informed about vaccinations. Particularly with exotic destinations, there is sometimes a high risk of infection with diseases that do not represent a risk in Europe.
Typical vaccinations for long-distance travel are:
- Yellow Fever
The local Tropical Institute is a good place to contact in this case.
What side effects can occur?
Even though vaccines are very safe, side effects can occur.
In most cases, the side effects of vaccination are mild. They include pain, swelling and redness at the injection site, mild fever, fatigue and headaches. This is usually a sign that the body is beginning to build up immunity to the disease.
If more serious side effects such as high fever, paralysis or an allergic shock occur, a doctor should be consulted immediately.
Vaccination and psoriasis – what do I have to consider?
Basically, the same recommendations apply to people with psoriasis as to people without the disease. However, there are a few points that should be considered.
Vaccinations protect against infections
Psoriasis is a chronic disease of the immune system. In severe cases, the therapy uses drugs that suppress the immune system (immunosuppressants). This makes the body more susceptible to infections. Here the right vaccinations can protect.
In cases of severe disease progression, psoriasis is treated by means of systemic therapy. The active ingredients are added internally (tablets, infusions) and act throughout the body. This can challenge the immune system.
If protective vaccinations are not available, they should be administered before the start of therapy. The same applies to any booster vaccines.
Vaccinations and psoriasis – Caution with live vaccines!
If vaccinations and psoriasis coincide, care must be taken, especially with live vaccines. Due to the treatment with live pathogens, live vaccines usually have a more intensive effect on the immune system than inactivated vaccines.
This applies to:
- During therapy with biologicals
- During treatment with methotrexate
- When Ciclosporin A is used
Travel vaccinations are often carried out with live vaccines. As these vaccinations are often given over a period of many weeks, they must be administered in consultation between a vaccination specialist and the doctor treating the patient.
What are the risks of vaccinations and psoriasis?
In general, vaccinations and psoriasis involve the same risks as in “healthy” people. Therefore, all common side effects can occur.
However, when vaccinations and psoriasis meet, another possible reaction occurs. Vaccinations can trigger or worsen psoriasis. This connection has not yet been clearly proven, but there are indications that there is a connection.
The Koebner phenomenon is often mentioned in this context. The Koebner phenomenon (also known as isomorphic irritation) is a rare skin reaction to mechanical, thermal or other irritation. One form of this irritation can be vaccination.
Vaccination and psoriasis – is there a vaccine?
For years scientists have been looking for a vaccine against psoriasis.
There is still no approved vaccination, but some promising approaches are bringing hope to the topic of vaccination and psoriasis.
Studies are investigating drugs that partially deactivate the immune system. This will significantly reduce symptoms. In some test subjects, the symptoms disappeared completely. Other studies are investigating the blocking of certain proteins in the body that reduce the overreaction of the immune system in psoriasis.
Vaccination and psoriasis go hand in hand
Used correctly and carefully considered, vaccination and psoriasis go hand in hand. It is important to be clear about individual needs. The best way to find out which vaccinations are sensible is to talk to your doctor. Even if it is not always easy to find one’s way through the large range of vaccinations, it is worthwhile to consider the topic. In this way, optimal protection is provided without overburdening the body with possibly unnecessary vaccinations.
How do vaccines work?
Vaccines train the immune system and prepare it for pathogens. This can happen with live vaccines or with inactivated vaccines. After administration, the body develops a protective mechanism (antibody) against an infection.
Vaccination and psoriasis – what do I have to watch out for?
Adequate vaccination protection is important for people with psoriasis. Nevertheless, vaccination must be carried out carefully. Again and again, we have seen cases in which the vaccination has caused psoriasis.
Is there a vaccination against psoriasis?
Although there are some promising studies, there is no approved vaccine against psoriasis yet.
Find all sources
Impfen Pro & Contra: Das Handbuch für die individuelle ImpfentscheidungMartin Hirte, Knaur MensSana Verlag, 2018
Gute Impfung – Schlechte Impfung: Der umfassende RatgeberBert Ehgartner, Ennsthaler Verlag, 2019
Study Finds Potential Vaccines for Psoriasis, Allergies, and Alzheimer Diseasevia: https://www.ajmc.com/newsroom/study-finds-potential-vaccines-for-psoriasis-allergies-and-alzheimers-disease#:~:text=Combining%20a%20tetanus%20vaccine%20with,disease%2C%20according%20to%20a%20study. (Stand Juli 2020)
Bernd is one of the founders of Simply Psoriasis. He has been suffering from psoriasis for more than 20 years, but sees the chronic skin disease with more composure than a few years ago (which was a hard work). Nevertheless, he is very keen to make psoriasis easier and more socially accepted.