Efficacy of COVID-19 Vaccine in Patients With Atopic Dermatitis

In patients with atopic dermatitis and those treated with immunosuppressive medications, the Pfizer BNT162b2 mRNA COVID-19 vaccine is efficacious against SARS-CoV-2 infection, and related hospitalization and mortality, according to study findings published in the American Journal of Clinical Dermatology.

Effects of the COVID-19 pandemic are being mitigated by vaccines, 2 of which are messenger RNA (mRNA) vaccines. The immune response to mRNA vaccines in patients with immune-mediated diseases and those patients treated with immunosuppressive medications has not been thoroughly investigated, the study authors noted.

Researchers sought to investigate the efficacy of mRNA COVID-19 vaccine among patients with AD, to determine the effect of immunosuppressive medications on the effectiveness of this vaccine.

To accomplish this, they conducted a population-based retrospective cohort study of 77,682 adult patients with AD (61.5% women; 84.9% Jewish ancestry; mean at onset of the pandemic 41.9±18.6 years of age) in the database of Clalit Health Services, Israel. In total, 58,582 patients had completed 2 doses of the Pfizer mRNA COVID-19 vaccine from December, 2020 to June, 2021. An overwhelming majority (92.7%) had mild AD, and during the pandemic, 597 patients were treated with immunosuppressive medications.

Researchers said, “Vaccinated patients with AD (compared with unvaccinated patients with AD) demonstrated a significantly decreased risk of SARS-CoV-2 infection (adjusted HR, 0.20; 95% CI, 0.16–0.26; P <.001), COVID-19-associated hospitalization (adjusted HR, 0.08; 95% CI, 0.04–0.18; P <.001), and COVID-19-associated mortality (adjusted HR, 0.04; 95% CI, 0.01–0.20; P <.001).” The level of protection provided by the mRNA vaccine for COVID-19 was unaffected among the 597 patients (0.8%) treated with immunosuppressive medications (adjusted HR, 0.95; 95% CI, 0.13–6.81; P =.958).

Study limitations included the small sample size of COVID-related patient hospitalization and death, possible misclassification of dermatitis, a wide variation in demographic and clinical features between vaccinated cohort and unvaccinated cohort, and the small sample size of patients with immunosuppressive medication treatment.

The researchers concluded the Pfizer mRNA vaccine “decreased the risk of SARS-CoV-2 infection, COVID19-associated hospitalization, and mortality by 80, 92, and 96%, respectively. In the small percentage of patients taking immunosuppressive drugs or undergoing phototherapy, these treatments did not hamper the effectiveness of the vaccine in protecting against SARS-CoV-2 infection.”

Disclosure: A study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Kridin K, Schonmann Y, Onn E, Bitan DT, Weinstein O, Cohen AD. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. Published online March 16, 2022. doi:10.1007/s40257-022-00672-5