The main vaccines against psoriasis

As an adult, you think you need to get vaccinated against influenza or diseases in distant countries. All other vaccines were made in childhood – if the parents were not fierce opponents of the vaccine. This is not true, unfortunately. Anyone who is immunocompromised by medication or because of his age is at risk of acquiring dangerous infectious diseases. In addition to standard vaccines, pay for immuno-compromised health insurance and vaccinations that others do not receive. Even then, if only you can say that the immune system in the near future will be weaker, for example through a planned therapy with a biological.

Vaccination can prevent serious infections

Dr. Christian Schönfeld from Tropical Institute of Berlin gives regular lectures to dermatologists. In July 2019 he was part of our Berlin self-help group. His message is clear: medications for internal psoriasis, such as biologics, weaken the immune system. These include high dose cortisone, for example in psoriatic arthritis (or atopic dermatitis). To prevent serious infectious diseases, those affected must be vaccinated. This concerns those who current or to come up should be treated with immuno-inhibitory drugs.

Only the benefits for patients and doctors
Patients can legally claim these benefits. Health insurance companies pay the fees. The doctor is paid more for the vaccination; the vaccine is not included in the budget. Unfortunately, not all dermatologists know how important some vaccines are for their psoriasis patients. Therefore, according to Schönfeld, sufferers should specifically address their dermatologist. He advises to deal urgently with the subject "vaccination". Psoriasis is rarely triggered by vaccination. Exacerbations of existing psoriasis are unknown.

Which vaccines are missing, show antibodies

People with psoriasis who are severely or moderately affected should clarify as soon as possible what they have been vaccinated until now (vaccination status). It would be ideal if it could be read directly from the vaccination card. This is not always gaps. A blood test can also determine if and against whom a person has been vaccinated. You can tell by which antibody against infectious diseases in the blood. These antibodies form the immune system to target pathogens. However, they can only be formed if the immune system knows the pathogens (viruses or bacteria). Vaccination with the pathogen is a Ability to form the immune system. Unfortunately, this does not last a lifetime in all diseases. In these cases, the immune memory must be helped by a booster vaccination. Another way to make antibodies is to live through the infectious disease itself. After that, one is immunized for life – but only if the infection by a virus is caused but not at bacterial diseases caused.

Vaccinate before starting treatment

Anyone treated with an immuno-inhibitor drug should not receive a live vaccine. It is too strong for the weakened immune system to produce antibodies. Live vaccines are given against measles, mumps, rubella, chicken pox and long-distance travel against yellow fever. You must be at least four to six weeks old before receive the drug treatment. All other vaccines are done with dead vaccines. They can indeed at the same time be administered with the psoriasis medication. But they work better when they too previously to be administered, Dr. Schoenfeld. A dead vaccine should work better even if it is given in a phase of regression of psoriasis (remission).

Stopping the drug in live vaccines
Those who have not already been vaccinated against measles, mumps, rubella or chicken pox, or who have not experienced these diseases, should be vaccinated – regardless of age. For all live vaccines: if they are not before At the beginning of the therapy, the immunosuppressive agent should be stopped. This is only when it is completely degraded by the body, can be vaccinated. How long does it last should be discussed with the attending physician. In principle, a three-month security period applies. But supplements taken daily or weekly are broken down faster than those injected every 4 or 8 weeks or once a quarter.

Against who should be vaccinated

Risk of shingles in immunodeficiency
Anyone who has ever had chicken pox should be vaccinated against immune deficiency for shingles (herpes zoster). When the immune system is inhibited, dormant varicella viruses in nerve cells can become active again. This occurs fifteen times more often than with people in good health, Dr. Jutta Weinerth (Ernst Bergmann Hospital, Potsdam). The pain caused by shingles is extremely heavy and difficult to treat. They are the most common cause of suicide (suicide) among people over 70 years of age. Schoenfeld. This vaccine has been taken over by health insurance since May 2019. But that does not help against classical herpes, for example. on the lip.

Vaccination against yellow fever during long distance journeys
against yellow fever You can vaccinate when traveling to tropical and subtropical regions of South America or Africa. As it is a live vaccine, vaccination should be maintained until the drug breaks down for psoriasis. It takes 10 days for antibodies against yellow fever to form. Then you can continue treatment with the psoriasis medication.

Hepatitis B vaccine: money pays for immunodeficiency
You should always go against Hepatitis B to be vaccinated. The virus causes severe, sometimes chronic liver inflammation. Before giving an immunoinhibitory drug, it must be checked whether antibodies (anti-HBF) are present in the blood. If not, he must be vaccinated. The goal is to durable to have at least 100 units of anti HBF in the blood. This value must be verified each year. Vaccine protection does not last a lifetime because part of the immune system is lost. The funds only cover the costs of the over-18s if there is an immunodeficiency or is foreseeable.

Pneumococcal vaccine: a better medicine for immune deficiency
pneumococcal are bacteria that can cause many inflammations, especially in the lungs, the middle ear and meninges. Most importantly, children and people aged 50 and over are at risk. The health insurance pays the vaccine up to the 23rd month of life, from age 60 and for immunocompromised people of all ages. Many people are not vaccinated against this disease. Schoenfeld. The most effective method is to vaccinate first with Prevenar13, then with Pneumova23. This combination, however, only affects toddlers and immunocompromised patients. Older people are vaccinated only with Pneumova23. But this does not allow the immune system to develop memory cells. Therefore, the vaccine protection of this group must be updated every 6 years.

Meningococcal vaccine: cash money is used to compensate for immunodeficiency
meningococcus are bacteria that can cause meningitis (meningitis) and septicemia (sepsis) resulting in significant damage. There are 13 different types. Meningococcus B is most often found in Germany. Schönfeld, the Trumenba vaccine better than Bexsero. Vaccination will also be directed against meningococcal ACWY. Currently (2019), only the Nimenrix vaccine is available. Both vaccines are useful if you have not developed antibodies against it. For those over 18, they are only paid for immunosuppressed by the coffers.

Influenza vaccine: the best product of cell culture
Dr. Schönfeld recommends that all chronic patients be on their guard influenza (Influenza). As influenza viruses are constantly changing, a new combination of protective agents is developed each year. In Germany, this is the Standing Committee on Immunization of the Robert Koch Institutewho recommends which vaccines to use for each influenza season. Despite vaccination, there is no 100% protection. So, for example, during the 2017/2018 season, the influenza vaccine is the predominant influenza B virus. The health insurance companies also paid no preparation with potentiator (adjuvants). But these enhance protection, especially in the elderly and immunocompromised. Vaccines developed on cell cultures are preferable to hatched chicken eggs. It is only since the end of 2018 that the Flucelvax Tetra preparation is approved. Until then, vaccines without egg white were only allowed for severe allergies.

Tamiflu: low benefit, possible risk for adolescents
More problematic, it seems with the controversial flu vaccine Tamiflu. The Roche manufacturer did not publish data at that time to claim to have a very good effect. The active substance itself (oseltamivir) is suspected to have caused serious neurological disorders or even suicides in adolescents. Supervisory authorities EMA and BfArM however, assume that there is no "causal link" with Tamiflu vaccination for documented cases around the world. Dr. Schönfeld reported that, understandably, only young people from Scandinavia were affected in Europe.

Activator of active substance in harmless amounts

Critics of the vaccination claim that active ingredients such as aluminum are dangerous for health. This is not fair: the man takes the everyday on the aluminum food. The amount of vaccination is extremely low and barely detectable. In addition, vaccination protects against dangerous infections. In this sense, the extremely low excess of aluminum is acceptable. The same goes for mercury: very few vaccine sera contain ethylmercury. It also remains very short in the body – as opposed to methylMercury, the actual toxin. We take it daily in the food.

Vaccination was successful?

The immune system must react to the vaccine. If it detects a foreign substance, it will try to fight it and form antibodies for the future. Temporarily, the site of injection can be swollen, it can hurt or the arm can be difficult to move. You may also have a fever for a while, head or body aches or discomfort. These are all symptoms of the immune system forming antibodies (vaccine response). On average, men are less sensitive to vaccines than women. Testosterone slows the formation of antibodies and cytokines.

In case of doubt about the success of the vaccine, it can be determined in the blood if the desired antibodies have been formed. It may be necessary to vaccinate again, if necessary with an active ingredient enhancer.

No vaccine gives him 100% protection. Therefore, family members and other close contacts should be vaccinated.

Inoculate infants

Infants are first vaccinated against rotavirus after 6 weeks. All other vaccinations take place the first time after 2 months. However, babies can not be successfully vaccinated if, during pregnancy, the mother uses an immunocompromising drug, eg. took a biological product. The umbilical cord could also weaken the immune system of the child. Therefore, no psoriasis medication is approved for pregnancy. But: Cimzia (certolizumab), an anti-TNF alpha-blocker, proved that the active substance did not pass into the umbilical cord. These babies can be vaccinated without hesitation.

Vaccine opponents spread false claims

Critics and opponents of vaccination behave like religious fanatics. They are not afraid to present "proofs" refuted for a long time, against a better knowledge. The facts can be read in serious publications.

postgraduate

  • Current information on immunization, Robert Koch Institute (RKI)
  • Flu: For whom a vaccination makes sense, Stiftung Warentest
  • Recommendations of the Standing Committee on Immunization (STIKO), updated annually
  • Advice on the immunization of patients with acquired immunodeficiency (STIKO, November 2005)
  • Special recommendations for people with chronic inflammatory diseases and for patients receiving immunosuppressive drugs. These include people with psoriasis and psoriatic arthritis, Bundesgesundheitsblatt, March 2019
  • Stop the myths about vaccination "(Stiftung Warentest, March 2018)
  • Immunization Myths in Verifying Facts "(minikama, April 2019)
  • The history of vaccination risk, Good medical-Online, November 2009)