QWhat do you tell patients on biologics about COVID vaccines?

Cynthia Lazzaro, DO

Cynthia Lazzaro, DO

Pacific Dermatology Specialists
Western University of Health Sciences
Los Angeles, CA

Many dermatology patients are on injectable biologic medications to treat chronic conditions ranging from atopic dermatitis to psoriasis to hidradenitis suppurativa.

Dupilumab is a biologic medication used for atopic dermatitis that does not have any immunosuppressive effects. These patients are not in an increased risk category and are encouraged to obtain the COVID vaccines/booster.

Injectable biologic therapies for psoriasis and hidradenitis suppurativa include those that fall into the category of TNF-alpha, IL-12/23, IL-17, and IL-13. These are immunoregulatory agents with the potential for increased risk of infection. There is significant literature that reaffirms patients on these immunosuppressive/immunomodulatory agents do not have a meaningful risk of acquiring COVID infection or having worse COVID outcomes.1 In fact, psoriasis and HS patients typically have comorbid metabolic syndrome which places them into a much higher risk group for COVID.2

The COVID vaccines/booster are highly effective at preventing COVID infections and/or decreasing the severity of the disease. I strongly encourage all my patients on biologic medications to get the COVID vaccination and booster shots and for them to continue their biologic therapies while receiving the series.


  1. Gelfand JM, Armstrong AW, Bell S, Anesi GL, Blauvelt A, Calabrese C, Dommasch ED, Feldman SR, Gladman D, Kircik L, Lebwohl M, Lo Re V 3rd, Martin G, Merola JF, Scher JU, Schwartzman S, Treat JR, Van Voorhees AS, Ellebrecht CT, Fenner J, Ocon A, Syed MN, Weinstein EJ, Gondo G, Heydon S, Koons S, Ritchlin CT. National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2-Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments. J Am Acad Dermatol. 2021 May;84(5):1254-1268.
  2. Lighter J., Phillips M., Hochman S., Sterling S., Johnson D., Francois F. Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission. Clin Infect Dis. 2020;71:896–897.