The efficacy of coronavirus disease 2019 (COVID-19) vaccination among patients on immunosuppressive or immunomodulatory therapy remains questionable, owing to the inadequate evidence for their protective effect in immunosuppressed state. 

The IADVL Academy have recommended for COVID-19 vaccination among dermatological patients on immunosuppressive therapy, after reviewing existing literature. It was stated that in this population, the risk of severe COVID-19 due to deferring vaccination should be weighed against concerns of lack of safety and efficacy data of these vaccines. In addition, the risk of worsening of primary dermatological condition by discontinuing or downgrading the immunosuppressive therapy should be weighed against the risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Presently, patients on immunosuppressive therapy should be advised COVID-19 vaccination unless they have an absolute contraindication against the vaccine. However, antibody testing post vaccination is not recommended. Furthermore, booster doses should not be considered in these patients, in lieu of presumed reduced efficacy. 

For patients on immunosuppressants, COVID-19 vaccination, in addition to COVID-appropriate behavior and vaccination of close contacts could aid in reducing the risk of acquiring SARS-CoV-2 infection and severe symptoms of the disease.

Source: Indian Dermatol Online J.2021;12(Suppl 1):S4-S11.