Psoriatic Arthritis and COVID Vaccines: What You Should Know

Table of Contents
View All
Table of Contents

Psoriatic arthritis (PsA) is an autoimmune condition that causes inflammation and swelling of the joints and other parts of the body. PsA treatments can weaken the immune system, putting those with the condition at higher risk of contracting COVID-19 and becoming seriously ill.

Vaccination has proven to be the most effective way to protect against severe illness from COVID-19. Individuals with PsA are no exception. However, due to the impact this condition has on the immune system, special considerations are necessary to enhance the protective benefits of the COVID-19 vaccine.

This article discusses the safety and effectiveness of the COVID-19 vaccine for individuals with PsA. It also outlines vaccine options and the benefits and risks of each.

Man getting COVID-19 vaccine

Ivan Pantic / Getty Images

Is It Safe to Get the COVID-19 Vaccine If You Have Psoriatic Arthritis?

If you've been diagnosed with psoriatic arthritis, you may be wondering whether the COVID-19 vaccine is right for you.

People who have been diagnosed with autoimmune conditions like psoriatic arthritis or who are taking immunosuppressive medications, like those prescribed for PsA, can have a weakened immune system. These individuals are at a higher risk for severe illness and death from COVID-19.

CDC Recommendations

The Centers for Disease Control and Prevention (CDC) recommends that immunosuppressed people and people with weakened immune systems be fully vaccinated against COVID-19 to protect themselves against severe illness.

Is the Vaccine Less Effective for Those With Psoriatic Arthritis?

Vaccines work by safely introducing a pathogen into the body that triggers an immune response. This signals the immune system to start building antibodies against that pathogen to prepare for future (and less safe) exposures.

People with a weakened immune system have a reduced immune response and may not be able to build up the same number of antibodies as someone with a healthy immune system.

For this reason, it's possible that the vaccine is less effective for those with psoriatic arthritis. Its effectiveness is further impacted by the medications sometimes prescribed for this condition and how they affect the immune system. That is not to say that the vaccine is ineffective against COVID-19; it is simply less effective in some cases.

Although the vaccine may not be as effective for people with PsA, it still provides an essential layer of protection against severe illness and death.

Ultimately, the benefits of being vaccinated far outweigh the risks of being unvaccinated and contracting the virus causing COVID-19.

Vaccination Options

There are currently three COVID-19 vaccination options approved or authorized by the U.S. Food Drug Administration (FDA): Pfizer, Moderna, and Johnson & Johnson (J&J).

Both the Pfizer and Moderna vaccines are authorized for individuals 6 months and older. The Johnson & Johnson vaccine is authorized those 18 years and older.

The CDC recommendations outlined below are specifically for individuals who are moderately or severely immunocompromised, meaning they have a weakened immune system.

Currently, mRNA (messenger RNA) vaccines are the preferred vaccine type. These include either the Pfizer or Moderna vaccine.

Pfizer

The Pfizer COVID-19 vaccine is given as a two-dose series (three weeks apart) for those 5 years and older. It's recommended that those who are moderately or severely immunocompromised get a third dose at least four weeks after receiving their second dose in the primary series.

For children ages 6 months to 4 years, the vaccine is administered as a three-dose series, with the first two doses given three weeks apart and the third dose at least eight weeks later.

A booster is recommended for those 5 years and older, at least three months after completing the primary series.

A second booster shot is now recommended in some cases, including in people age 50 or older, people 12 and older who are immunocompromised, or people who received two doses of the J&J vaccine.

Moderna

Similar to the Pfizer vaccination series, the Moderna vaccine involves two doses, followed by a booster shot.

For all persons 6 months and older, the second dose should be administered at least 28 days after the initial dose. In immunocompromised people, a third dose is recommended at least 28 days after the second dose. A booster shot is also recommended for people 18 and older who completed the Moderna vaccine series.

A second booster shot is recommended for people age 50 or older, certain people who are immunocompromised, and those who received two doses of the J&J vaccine.

Johnson & Johnson/Janssen

The J&J vaccine series is a two-dose series that includes a J&J shot followed by a second dose of either the Moderna or Pfizer vaccine at least 28 days after the first dose. A booster with either Moderna or Pfizer is recommended at least two months after the second dose. A second mRNA booster dose is recommended for those age 50 or older and certain people who are immunocompromised.

Due to possible side effects, the FDA recommends that people seek one of the mRNA vaccines (Moderna or Pfizer) over a J&J vaccine series, where possible.

What This Means for People With PsA

For immunocompromised people with PsA, being fully vaccinated means completing your primary series (including additional doses) and getting all recommended boosters when eligible.

Vaccination Benefits

Being fully vaccinated can help improve the body's immune response, especially in people with PsA who may have a weakened immune system.

The COVID-19 vaccine has potentially life-saving benefits. According to the World Health Organization (WHO), getting vaccinated protects against serious illness, hospitalization, and death, and could even reduce your risk of transmitting the virus to other people.

Vaccination Risks

The COVID-19 vaccines have proven to be safe and effective. However, all vaccines have potential side effects, which are typically mild.

Some possible side effects of the COVID-19 vaccines include:

There is a risk of an allergic reaction, but these cases are very rare.

A 2021 study reported people experiencing psoriasis flare-ups (a related condition to PsA) after receiving the vaccine. However, more evidence is needed to determine the cause of these flare-ups.

Of note, a report from the same publication also noted PsA flare-ups resulting from COVID-19 infections.

Benefits vs. Risks

Based on the current research and recommendations, the benefits of receiving the vaccine far outweigh the risk of potential flare-ups.

Should I Get the COVID-19 Vaccination Booster If I Have Psoriatic Arthritis?

The National Psoriasis Foundation COVID-19 Task Force has aligned with current CDC guidance and recommends that individuals with psoriatic arthritis receive a booster dose of a COVID-19 vaccine.

The vaccine schedule outlined in a previous section indicates that people who have a weakened immune system should receive a total of four doses of either available mRNA vaccines (Pfizer or Moderna) or a combination of one dose of the J&J vaccine with two follow-up doses of the Pfizer or Moderna vaccines. Those who are eligible, should also get a second booster dose.

A 2022 study that looked at the impact of booster doses on people who have a weakened immune system found that the immune response in people who had received a second dose of the vaccine was 41% and increased to 67% after a third dose. The study also found that people who had little to no immune response to the initial two-dose series saw a 44% increase in antibodies after receiving a booster dose.

Summary

Being fully vaccinated against COVID-19 is the best way for people with psoriatic arthritis to protect themselves against the virus. Although the vaccines may be slightly less effective for those taking immunosuppressive medications that treat PsA, the immune-boosting benefits make a big difference in the severity of COVID-19.

There is a possible risk of PsA flare-ups as a result of the vaccine, but the same risk exists from infection with COVID-19. It's encouraged to talk to a healthcare provider about any concerns.

A Word From Verywell

If you have an autoimmune condition like psoriatic arthritis, you are likely wondering how COVID-19 and the vaccine may affect you. Research has shown the effectiveness of the COVID-19 vaccines, even in immunocompromised people. Talk to your healthcare provider if you have any questions or concerns about the COVID-19 vaccine and other ways you can protect yourself against the virus.

Frequently Asked Questions

  • Can the COVID-19 vaccine cause a psoriatic arthritis flare up?

    There have been reports of the COVID-19 vaccine causing psoriatic arthritis flare-ups, but, similarly, contracting the virus itself can lead to flare-ups as well. Vaccination is the best way to protect yourself against COVID-19.

  • Is the COVID-19 vaccine safe for people with psoriatic arthritis?

    The COVID-19 vaccine is safe and recommended for people with psoriatic arthritis. It helps to boost the immune response in people who may have a weakened immune system.

  • Is the COVID-19 booster safe for people with psoriatic arthritis?

    Yes, it's both safe and recommended for people with psoriatic arthritis to receive a booster dose.

  • Does the AstraZeneca antibody drug AZD7442 (Evusheld) protect against COVID-19?

    Research has shown that a single dose of AZD7442 can provide protection against COVID-19. It also reduces the risk of death or serious illness from the virus if contracted (when taken after symptom onset).

Was this page helpful?
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Rheumatology. Psoriatic arthritis.

  2. Centers for Disease Control and Prevention. COVID-19 vaccines for people who are moderately or severely immunocompromised.

  3. Pollard AJ, Bijker EM. Guide to vaccinology: from basic principles to new developmentsNat Rev Immunol. 2021;21(2):83-100. doi:10.1038/s41577-020-00479-7

  4. Food and Drug Administration. Coronavirus (COVID-19) update: FDA authorizes Moderna and Pfizer-BioNTech COVID-19 vaccines for children down to 6 months of age.

  5. Centers for Disease Control and Prevention. Johnson & Johnson’s Janssen COVID-19 vaccine: overview and safety.

  6. Centers for Disease Control and Prevention. Pfizer-BioNTech COVID-19 vaccine: overview and safety.

  7. Centers for Disease Control and Prevention. COVID-19 vaccine boosters.

  8. Centers for Disease Control and Prevention. Moderna COVID-19 vaccine: overview and safety.

  9. U.S. Food & Drug Administration. Coronavirus (COVID-19) update: FDA limits use of Janssen COVID-19 vaccine to certain individuals.

  10. World Health Organization. Coronavirus disease (COVID-19) vaccines.

  11. Centers for Disease Control and Prevention. Possible side effects after getting a COVID-19 vaccine.

  12. Centers for Disease Control and Prevention. Safety of COVID-19 vaccines.

  13. Huang YW, Tsai TF. Exacerbation of psoriasis following COVID-19 vaccination: report from a single centerFront Med. 2021;8:812010. doi:10.3389/fmed.2021.812010

  14. Zhou Q, Vadakekolathu J, Watad A, et al. Sars-cov-2 infection induces psoriatic arthritis flares and enthesis resident plasmacytoid dendritic cell type-1 interferon inhibition by jak antagonism offer novel spondyloarthritis pathogenesis insightsFront Immunol. 2021;12:635018. doi:10.3389/fimmu.2021.635018

  15. National Psoriasis Foundation. COVID-19 task force guidance statements.

  16. Parker EPK, Desai S, Marti M, et al. Response to additional COVID-19 vaccine doses in people who are immunocompromised: a rapid review. Lancet Global Health. 2022;10(3):e326-e328. doi:10.1016/S2214-109X(21)00593-3

  17. Mahase E. COVID-19: AstraZeneca says its antibody drug AZD7442 is effective for preventing and reducing severe illness. BMJ. 2021:n2860. doi:10.1136/bmj.n2860

  18. Levin MJ, Ustianowski A, De Wit S, et al. Intramuscular AZD7442 (Tixagevimab–cilgavimab) for prevention of COVID-19N Engl J Med. 2022:NEJMoa2116620. doi:10.1056/NEJMoa2116620