• by Rishma Parpia | PublishedAugust 14, 2023 | The Vaccination Reaction

A 2023 scientific review published in the journal Biomedicines reported cases of new onset or worsening of psoriasis following COVID-19 shots.1 Patients in the scientific review either received mRNA-based biologics, including Pfizer/BioNTech Comirnaty or Moderna/NIAID’s Spikevax, or viral vectored vaccines that included AstraZeneca/Oxford University’s Vaxzevria or Johnson & Johnson/Janssen’s Ad26.COV2.S vaccine.2

Psoriasis is a chronic, inflammatory skin disorder with symptoms that include a rash with itchy and scaly patches that commonly occur on the knees, elbows and scalp.3

Review Analyzed 49 Studies With Pfizer COVID Shot Linked to Most Psoriasis Reaction Reports

The authors of the study searched the current medical and scientific literature using the following databases: PubMed, Cochrane Skin, Embase, EBSCO, MEDLINE, and Google Scholar, for studies published before June 1, 2023.4 The review included 49 studies involving 134 patients, of which 37 percent were male, 48.1 percent were female, and 14.8 percent were an unreported gender. The average age was 54.4 ± 20.9 years.5

The most common shots associated with psoriasis onset were Pfizer/BioNTech’s Comirnaty at 55.5 percent, followed by AstraZeneca/Oxford University’s Vaxzevria at 18.5 percent and Moderna/NIAID’s Spikevax at 11.1 percent.6

The average time between administration of those shots and new onset psoriasis was 10.3 ± 6.4 days. Most cases reportedly were mild and were treated with either topical treatments (33.3 percent), systemic drugs (11.1 percent), biologics (18.5 percent), Apremilast–an oral medication (7.4 percent), or no treatment (3.7 percent).

A total of 107 cases of psoriasis exacerbation were reported, with 57 percent male and 43 percent female, with an average age of  56.5 ± 13.4 years old. The most psoriasis-associated shot was Comirnaty at 61.7 percent, followed by Vaxzevria at 19.6 percent and Spikevax at 18.7 percent.7

The average time between administration of those shots and psoriasis exacerbation was 13.7 ± 14.4 days. Biologic treatment was most commonly used on 36.4 percent of patients, with first-time biologic treatments making up 30.8 percent of cases. Moderate to severe forms of psoriasis were reported resulting in the use of systemic drugs and biologics in 44 percent of patients.8

Most COVID Shot Reactions Involving Psoriasis Not Reported

The authors of the review noted:

We hypothesize that cases of psoriasis exacerbations or de novo disease developed following vaccination were underestimated, since not all patients seek medical advice due to the limited severity of the disease, tending to self-medicate (particularly in patients affected by psoriasis who are more accustomed to self-medication with topical drugs, reducing the need for medical advice in the case of mild forms of the disease), and many reactions have not been reported.9