The Impact of Immune-Modifying Treatments for Skin Diseases on the Immune Response to COVID-19 Vaccines: A Narrative Review

The review, based on 25 studies, investigates the impact of immune-modifying treatments for skin diseases on the immune response to COVID-19 vaccines. It found that individuals receiving such therapy, including methotrexate and rituximab, were less likely to have a detectable antibody response compared to healthy controls. However, most individuals on these therapies showed successful seroconversion after the second vaccine dose. The review also found that these individuals had lower levels of spike-specific IgG antibodies. The timing of rituximab treatment in relation to vaccination can influence the vaccine response, with a more favorable response when there was a greater time interval between treatment and vaccination. The review suggests that temporary cessation of methotrexate following vaccination may increase vaccine efficacy. The review calls for further research to understand the complex humoral and cellular response to subsequent vaccine doses, including against newer variants of concern.