Psoriatic Arthritis and COVID Vaccines: What You Should Know

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.

Should You 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.

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.

Vaccination Options

There are currently four COVID-19 vaccination options approved or authorized by the U.S. Food Drug Administration (FDA): Pfizer, Moderna, Johnson & Johnson (J&J), and Novavax. The CDC recommends that everyone 6 months and older receive the COVID-19 vaccine and a booster shot if eligible.

Both the Pfizer and Moderna vaccines are authorized or approved for individuals 6 months and older. The Novavax vaccine is authorized for emergency use in people 12 years and older. The J&J COVID-19 vaccine is authorized for emergency use in adults 18 and older.

Updated bivalent boosters from Pfizer-BioNTech and Moderna received Emergency Use Authorization (EUA) from the FDA. The CDC recommends one bivalent booster shot for all people 6 months and up, but which booster you get may depend on which vaccine series you initially received.

In limited situations, a monovalent Novavax booster dose may be used in people ages 18 and older who are unable to receive an mRNA vaccine.

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

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 bivalent booster shot is recommended two months after receiving a primary COVID-19 vaccination series or after the last booster dose. Children ages 5 years and older can get the bivalent Pfizer booster and for children under 5 years, the third dose of the primary series is a bivalent vaccine.

Immunocompromised people have a higher risk of being hospitalized, becoming severely ill, or dying from COVID-19. As a result, the CDC recommends that some immunocompromised people receive an extra primary dose of the Pfizer or Moderna vaccine. In addition, they should receive a bivalent booster dose.

Moderna

The Moderna vaccine is given as a two-dose series.

For all persons, 6 months and older, the second dose should be administered at least 28 days after the initial dose. In immunocompromised people, an additional primary series dose is recommended at least 28 days after the second dose. An updated bivalent booster shot is also recommended for people 6 and older who completed the Moderna vaccine series.

Johnson & Johnson/Janssen

The J&J vaccine is a single-dose vaccine for those 18 years and older. For people who are moderately or severely immunocompromised, the CDC recommends that the J&J vaccine is followed by a dose of an mRNA vaccine (Pfizer or Moderna) at least 4 weeks after the J&J dose. An updated bivalent booster is also recommended, either Pfizer or Moderna, at least 2 months after the second dose.

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

Novavax

The Novavax vaccine is given as a two-dose series, three to eight weeks apart. It is the first protein-based COVID-19 vaccine authorized in the U.S.

An updated bivalent booster from Pfizer or Moderna is recommended at least two months after completing the Novavax series.

In limited situations, a monovalent Novavax booster dose may be used in people ages 18 and older who are unable to receive an mRNA vaccine.

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:

• Pain, redness, or swelling at the injection site
• Fever
• Headache
• Fatigue
• Muscle pain
• Chills
• Nausea

Some people have experienced serious health events after COVID-19 vaccination, 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.

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

CDC guidance recommends that individuals with psoriatic arthritis receive an updated bivalent booster dose of a COVID-19 vaccine after completing their primary series.

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

The best way for people with psoriatic arthritis to protect themselves against the virus is to stay up to date with their COVID-19 vaccines. Although the vaccines may be less effective for those taking immunosuppressive medications that treat PsA, the immune-boosting benefits may 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.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.