Do potential side effects mean vaccines should be avoided?

Vaccines offer protection from serious, preventable illness. Most children and adults can reap these protective benefits, with minimal health risks, by following the Centers for Disease Control and Prevention’s recommended vaccination schedule. If you have psoriasis, however, you may need to work more closely with your doctor, as vaccinations can be more complicated.

For example, for some people with psoriasis, injected vaccines may increase the risk of a psoriasis flare at the injection site. This reaction, known as Koebner’s phenomenon, can occur when your immune system — already in overdrive in psoriasis, causing skin cells to form too rapidly — rushes in to heal the wound caused by the injection. For those who experience Koebner’s phenomenon, any skin trauma, from sunburn to surgical wounds, can cause psoriasis patches to form at the site of the injury.

In addition, live vaccines aren’t safe for you if you’re scheduled to start treatments that alter or suppress your immune system, including methotrexate or biologics. Live vaccines are made with a weakened (attenuated) amount of an actual virus. Like all vaccines, those that contain a live virus help your immune system recognize and produce its own protection (antibodies) against infection. However, when your immune system is suppressed, exposure to a live virus may cause the infection the vaccine was made to prevent.

Some vaccines, such as the flu (influenza) vaccine, are available both as a live vaccine — administered as a nasal spray — and a killed (inactivated) vaccine, administered as a shot. Your doctor can help you consider the risk of serious infection from live-virus exposure against the risk of Koebner’s phenomenon from a skin injection. The right choice for you in such cases will depend on your current health and medical treatments.

Experts agree that the potentially lifesaving benefits of vaccinations significantly outweigh the risks in people who have psoriasis. But it’s important to talk with your doctor about the right vaccination schedule for you.

Sept. 12, 2017 See more Expert Answers