Could covid vaccine affect efficacy of psoriasis treatments

[Fred]

What are your thoughts on the covid vaccine having an affect on the efficacy of your psoriasis treatment. ?

I'm on Tremfya and have noticed the psoriatic arthritis isn't doing so well with my last two shots, and as usual I always try to understand why. But apart from thinking the Tremfya isn't working as well as it did, I'm stumped for an answer.

But I started looking at when I took my Tremfya in comparison with the dates of the Pfizer covid vaccine to see if there could be a link.

Tremfya:

24 April
19 June

Pfizer

05 May
14 June

When I look back at my journal it's 15 May that I said the psoriatic arthritis score had shot up from 7 to 12, since then my score has slowly gone up and it's now on 16.

Here is what I'm wondering.

Tremfya is slowing things down and doing it's job, but then along comes Pfizer which wants to create antibodies. So there is a boxing match going on in my system and both drugs are knocking hell out of each other.

The psoriatic arthritis is getting worse because Tremfya is now having to punch away at Pfizer whilst at the same time fight off psoriasis and psoriatic arthritis.

If this is the case its going to go on for a while as I have my third Pfizer jab on 15 July less than 4 weeks after my Tremfya. 

Thoughts ?

[Caroline]

Your immune system is set to work, when you get a Covid vaccination. Indeed it has to create anti-bodies.
Tremfya is pushing down certain elements of the immunesystem. Are they involved in the making of the anti-bodies? I would not know.
What we do Certainly know is that a systemwide immune suppressor like MTX, has a negative effect on the making of the antibodies for Covid. So that will have an influece.

On the other hand.. the vaccination pushes up the activity of the immune system, as this is already overactive with Psoriasis and Psoriatic Arthritis, one can logically imagine that this also becomes worse.

On the site of the Dutch association some questions on this subject were also asked and answered by I dermatologist. I have translated them and they are below.

Is it the case that a flare-up of psoriasis due to covid vaccination is temporary, or is there an effect that can last longer?
It is likely that a flare-up of psoriasis due to covid vaccination is indeed temporary. A vaccination triggers an immune response and that can lead to an increase in psoriasis. This is not seen in every person with psoriasis, by the way. The risk seems small, but is currently being investigated in scientific studies. The recommendation is that every person with psoriasis should be vaccinated.

Is it to be expected that with every covid repeat vaccination, which may come annually, this can always occur?
No, the effect of a temporary flare-up of the psoriasis does not have to occur consistently with subsequent vaccinations. Therefore, there is no contraindication for a 2nd injection if a flare-up of the psoriasis has occurred during the 1st injection. It is wise to treat the psoriasis properly. All psoriasis treatments can be combined with covid vaccination and do not need to be interrupted.

So yes, the dermatologist thinks there can be a flare up. His second answer though is not consistent with your experiences Fred. I have seen the dermatologist speaking in a webinar last week, and he seems to be quite knowledgeable.

[jiml]

Since my covid vaccinations I have noticed my shoulders waking me most nights with pain. But rolling onto my back I'm able to drop off to sleep again ... Then it's an elbow in the ribs that wakes me when I start snoring 

[Fred]

@Caroline I would think a lot of dermatologists and other autoimmune specialists are looking into it, and this is an unknown for all of them. But I wonder if they have ever looked at the usual flu jab in relation to a psoriasis treatment. My thinking is they are not much different, but I have never had a flu jab so couldn't comment.

@Jim That is very interesting, what you are describing sounds very familiar. I have this thing of rolling from side to side in pain, I no longer lay on my back since they said I had sleep apnea though.

[KatT]

I haven't noticed any difference but then again, I have lots going on health wise.

That being said, it does make sense that it would affect the treatment.

[Fred]

I haven't noticed any difference but then again, I have lots going on health wise.

That being said, it does make sense that it would affect the treatment.

Yes this is all new to me, so I don't know if other vaccines do or can work against a treatment. I think I will be bringing it up at my next appointment in September.

[mataribot]

The technology used to make these vaccines are fundamentally different then prior vaccines and rushed onto the market. It’s not surprising it may cause flares while the flu shot doesn’t.

[Turnedlight]

Yes I’m guessing as the whole point of the treatment is to dampen immune activity and the vaccine is to excite immune activity it seems likely we might notice something.
I’ve been aching more recently, especially my ankle and I have to sort of hang it out of the bed at night! I think the immune response to the jab can go on for weeks? But hopefully settle down in the end.

[Fred]

The technology used to make these vaccines are fundamentally different then prior vaccines and rushed onto the market. It’s not surprising it may cause flares while the flu shot doesn’t.

Good point Mata.

Yes I’m guessing as the whole point of the treatment is to dampen immune activity and the vaccine is to excite immune activity it seems likely we might notice something.
I’ve been aching more recently, especially my ankle and I have to sort of hang it out of the bed at night! I think the immune response to the jab can go on for weeks? But hopefully settle down in the end.

Weeks I have my third one on the 15 July so it could be August till things settle down, unless like Caroline said it's the first jab that causes the biggest problem.

[Caroline]

The technology used to make these vaccines are fundamentally different then prior vaccines and rushed onto the market. It’s not surprising it may cause flares while the flu shot doesn’t.

Good point Mata.

Yes I’m guessing as the whole point of the treatment is to dampen immune activity and the vaccine is to excite immune activity it seems likely we might notice something.
I’ve been aching more recently, especially my ankle and I have to sort of hang it out of the bed at night! I think the immune response to the jab can go on for weeks? But hopefully settle down in the end.

Weeks  I have my third one on the 15 July so it could be August till things settle down, unless like Caroline said it's the first jab that causes the biggest problem.

Yes, it takes a few weeks for the vaccine to be fully effective, so I guess it is busy in your body during, I hope, about 2 weeks.
My webinar doc said that the immuneresponse should be less the second time.
From around me I hear that a lot of people don't react to the first jab and that they get a little sick with the second jab.