For patients with psoriatic arthritis receiving nonlive or live vaccines, evidence-based recommendations are crucial to determine whether systemic therapies for psoriasis and/or psoriatic arthritis should be paused or continued. The National Psoriasis Foundation Medical Board and COVID-19 Task Force, along with infectious disease experts, developed 22 consensus statements using a modified Delphi process to address vaccine efficacy and safety in this context.

The key recommendations suggest continuing most oral and biologic therapies without modification for patients receiving nonlive vaccines, although interruption of methotrexate should be considered. For live vaccines, it’s recommended to discontinue most oral and biologic medications before and after administration. Specific guidelines suggest discontinuation of most biologic therapies, except abatacept, for 2-3 half-lives before live vaccination and deferring the next dose 2-4 weeks after vaccination. However, studies regarding infection rates after vaccination are lacking.

Reference: Chat VS, Ellebrecht CT, Kingston P,. Vaccination recommendations for adults receiving biologics and oral therapies for psoriasis and psoriatic arthritis: Delphi consensus from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2024:S0190-9622(24)00243-3. doi: 10.1016/j.jaad.2023.12.070.