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.