IEC statement on New COVID 19 Vaccines

Dear IEC Friends,

Given the recent FDA approval of COVID-19 vaccines, and in light of their novel mode of efficacy involving mRNA, questions within the eczema community have been raised concerning potential risks associated with these novel vaccinations. In this letter, we aim to clarify some of these issues, and share our perspectives based on currently available data.

At the moment, no data are available from controlled clinical trials on patients with immunological disorders including atopic dermatitis, or patients undergoing immunosuppressive or immunomodulatory treatments. Nevertheless, data from other vaccine trials can be used to extrapolate the situation in the ongoing COVID-19 pandemic.

In patients undergoing immunomodulatory or immunosuppressive treatment, there is the general rule that live vaccinations are not recommended due to potential safety concerns. Importantly, all novel COVID-19 vaccines currently available are non-live vaccines, meaning that they cannot infect or spread on the skin or other organs. There is a possibility that in systematically treated eczema patients, SARS-CoV2 vaccines might be less effective than in healthy individuals. However, this should not lead to a delay or reduction in vaccination rates in these patients, as some immunocompromised patients are at higher risk for COVID-19, and only a broad immunization of the general population will ultimately help to control the pandemic.

To minimize the risk of COVID-19 infection and potential sequelae, the IEC encourages all patients with atopic dermatitis to get vaccinated at the first opportunity at which it is offered. There is currently no rationale in choosing one approved vaccine over the other. In general, the IEC does not recommend delaying or interrupting ongoing eczema treatments due to vaccination, especially in patients with high disease burden, as this approach is not supported by any data and might lead to disease exacerbation which by itself might negatively impact patient’s health. In certain situations, though, the first dose of the SARS-CoV2 vaccine might ideally be given before immunosuppressive treatment is initiated, if at all feasible, and patients stably treated with immunomodulatory agents might consider delaying the next dosing one week after each vaccination to potentially enhance the vaccination response, but this situation should be discussed with the treating physician beforehand. Please note, there is currently no data available for AD patients that supports this consideration. Given the potential reduced efficacy of the vaccine in patients undergoing immunosuppressive treatment, eczema patients should continue to follow advice to minimize risk of exposure even after vaccination until a broad immunity among the general population is obtained. Antibody responses to vaccination can be assessed and might help to inform about infection risks, but they do not fully reflect the immune status of the individual patient, as they do not capture the full response to vaccinations, which also involves immune cells that can directly respond to virus infection but cannot be detected in these assays. Thus, currently, there is no recommendation to assess seroconversion in vaccinated individuals, and precautions to avoid COVID-19 infection must still be adhered to.

Patients are advised to consult with their treating physician regarding their specific clinical circumstances before undertaking any changes in their medication regimen or taking the COVID-19 vaccine. The information in this statement is (i) solely informational and educational in nature and should not be construed as medical advice; and (ii) not intended to displace a health care provider’s best medical judgment based on the clinical circumstances of a particular patient or patient population. The information included in this statement reflects the current scientific and clinical knowledge at the time of publication, is only current as of its publication date, and is subject to change without notice as advances emerge.

The IEC will continue to monitor the situation closely and keep you informed as more information becomes available. We welcome questions and comments and encourage you to inform us regarding new data that might interest the IEC community.