A Web-Based Survey on Factors for Unvaccination and Adverse Reactions of SARS-CoV-2 Vaccines in Chinese Patients with Psoriasis

Abstract

Purpose: Vaccination is one of the most important strategy to prevent infections and control epidemics, but it also raises concerns about safety in patients receiving treatments. This study aimed to investigate the rate and factors for unvaccination, as well as adverse reactions and deterioration of disease after SARS-CoV-2 vaccination in psoriatic patients. Methods: A web-based questionnaire survey on SARS-CoV-2 vaccination, adverse reactions, and self-reported change of disease condition after vaccination in patients with psoriasis was conducted. Demographic, clinical, and psychological data were collected. Multivariable logistic regression was used in the estimation of associations. Results: A total of 788 psoriatic patients were investigated, and 68.9% reported SARS-CoV -2 vaccination. Younger age, use of interleukin-17 inhibitors, and symptoms of anxiety were associated with unvaccination. The incidence of overall adverse reactions after vaccination was 30.8%, and no severe adverse reaction was reported. The most common local and systemic adverse reactions were pain at the injection site and fatigue, respectively. Most patients reported no change in psoriasis after vaccination, while 16.6% and 4.4% reported slight and significant deteriorations of the disease, respectively. Nonadherence to treatment, symptoms of anxiety and depression, and perceived stress were associated with self-reported deterioration of psoriasis after vaccination. Conclusion: While a favorable safety profile of SARS-CoV-2 vaccines is observed, receiving biologic treatment is factor for unvaccination in patients with psoriasis. Deterioration of psoriasis reported by a small proportion of patients is partially attributable to mental and behavioral factors.

Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels

“…In our study, young age was associated with high prevaccination stress among individuals with normal anxiety, while older age was associated with high postvaccination stress in the mild-anxiety subsample. This result is in accordance with reports associating age with greater vaccine hesitancy and anxiety among Chinese population, psoriatic patients, and Indonesian adults [ 23 , 24 , 41 ]. Gender is known to exert significant effects on emotional processing and related emotional and behavioral consequences [ 54 , 55 ].…”

“…Anxiety symptoms among Chinese psoriatic patients were associated with high vaccine hesitancy. A slight to significant deterioration in psoriasis is reported in 20% of patients who experienced stress, anxiety, and depression after vaccination [ 41 ]. These reports may be justified by interactions taking place between anxiety and other factors.…”

“…Given a lack of assessment before vaccination, structural brain alterations detected in individuals with anxiety after the COVID-19 vaccine may be associated with the previous accumulation of physiological and structural adversities, which are further enhanced by vaccine uncertainty in certain groups [ 28 ]. Given the role of psychological and physical vulnerability (e.g., mistrust, allergy, chronic diseases) to distress following COVID-19 vaccine [ 24 , 41 ], it is necessary to identify and properly manage groups liable to high levels of psychological distress following vaccination to alleviate psychological and physical morbidity, which may ensue as a result.…”

“…Because the study did not follow up the respondents for a long time after receiving the vaccine, the nature of subsequent changes in the symptoms of distress and local pain in different groups is unclear. This issue needs to be handled in future studies, given that elevated mental symptoms after COVID-19 vaccine may deteriorate pre-existing pathologies if these symptoms are not properly managed [ 41 ]. Policymakers should adopt strategies that may combat conspiracy theories and increase participants’ vaccine preparedness [ 5 ].…”

New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review

“…Eighteen cases (6%) changed their treatment regimens completely to achieve disease control [ 11 , 12 , 38 , 43 , 45 , 54 – 58 , 60 , 61 ]. Among patients with psoriasis flares who were receiving prior treatment with biological agents, most (43%) were using IL-17 inhibitors [ 12 , 26 , 38 , 49 , 50 , 58 , 61 , 62 ], followed by TNF-α inhibitors (42%) [ 12 , 26 , 38 , 43 , 47 , 49 , 50 , 62 , 63 ], IL-23 inhibitors (10%) [ 12 , 43 , 49 , 50 , 62 ], IL-12/23 inhibitors (4%) [ 38 , 56 , 59 ], and TYK2 inhibitor (1%) [ 40 ]. Secukinumab [ 12 , 38 , 50 , 58 , 61 ] and adalimumab [ 12 , 26 , 38 , 50 ] were the most frequently used biological agents.…”