Unpacking how eczema impacts long-term mental health, even when skin is calm.
Published On: Oct 2, 2023
Last Updated On: Oct 2, 2023
The threat of another “tripledemic” — the nickname given to last year’s simultaneous outbreak of flu, COVID-19 and respiratory syncytial virus (RSV) — is on the horizon for this upcoming flu season. But unlike last year, RSV vaccines are now available to those 60 years and older, in addition to the existing flu and COVID-19 vaccines.1
The question for people with eczema is: What’s the safety of these vaccines and atopic dermatitis (AD)?
“These vaccines are generally quite safe for people with eczema,” said Dr. Joy Wan, assistant professor of dermatology and pediatric dermatologist at Johns Hopkins University School of Medicine. “In fact, for some people with eczema who are taking medications that might suppress their immune system, it is probably even more important to make sure one gets vaccinated to limit their risk of getting these common infections or having more severe symptoms.”
But how do the flu, COVID-19 and RSV vaccines work for those with AD? What should eczema warriors consider before getting these vaccinations?
A good place to start is by gaining a better understanding of each vaccine — what it does and how it may affect those with eczema.
The flu vaccine helps protect against the common influenza viruses for each upcoming flu season. The Centers for Disease Control and Prevention (CDC) recommends everyone 6 months and older in the U.S. get a yearly flu shot.2
For those with eczema who may have weakened immune systems, the general recommendation when getting a flu vaccine is to avoid vaccines that contain a live virus.
The COVID-19 vaccine works to help build immunity to the COVID-19 virus without exposing the immune system to the live virus. The CDC recommends everyone ages 5 and older should get one updated Pfizer-BioNTech or Moderna COVID-19 vaccine to stay up to date.3
There have been some reports from those with eczema who say they experienced flare-ups after a COVID-19 vaccination.4,5 However, these reports were generally rare and the reactions may be due to other factors outside of the vaccine itself.
The U.S. Food and Drug Administration (FDA) recently approved a new vaccine, Arexvy, designed to prevent RSV in those who are 60 and older. Prior to this new vaccine, monoclonal antibodies were used to help strengthen the body’s immune response to RSV — particularly for babies and toddlers who are considered high risk.
Since the new RSV vaccine was only recently approved by the FDA, there are no current reports or studies on how this vaccine may affect those with eczema.
For those with AD who are wondering if getting vaccinated for flu, COVID-19 and RSV is right for them, Dr. Wan provided her insight on the following questions.
Are people with AD more susceptible to getting sick from the flu, COVID-19 and RSV?
“Some people with atopic dermatitis might be more susceptible to getting sick from these infections or having worse symptoms,” Dr. Wan explained. “Especially if their immune system is relatively compromised by treatments that they are taking for their atopic dermatitis.”
What do dermatologists recommend to their patients with eczema regarding flu, COVID-19 and RSV vaccines?
“I recommend following the CDC guidelines for getting these vaccinations,” said Dr. Wan. “However, some patients with eczema may need to avoid getting ‘live’ vaccinations due to their immune status when on specific treatments for eczema.”
Should people with AD or food allergies get vaccines in a doctor’s office instead of a pharmacy or off-site vaccine clinic?
“The risk of having an immediate side effect, such as an allergic reaction, to vaccines is generally very low,” Dr. Wan explained. “If you have a history of allergy to vaccines or components of vaccines, then you may consider getting them in a doctor’s office. However, many pharmacies and off-site vaccine clinics are equipped to handle these situations as well. I would recommend that you get it at the place where you are most comfortable.”
Are people with eczema likely to flare after a vaccine?
“It is possible that some people with eczema can flare after a vaccine,” said Dr. Wan. “But it’s still only a minority of people with eczema and when a flare does occur after vaccination, it is usually easily manageable. If you have previously experienced eczema flares with vaccines, it may be worth making sure that you can see your dermatologist soon after the vaccine.”
What should people with AD ask their doctor when deciding if it’s safe to get these vaccines?
Dr. Wan explained that those with AD should ask about the risks and benefits of these vaccines based on their individual situation. “For example,” she said, “some treatments for eczema may place one at greater risk for catching infections or having more severe symptoms with these types of infections. Check with your doctor about whether there are any special considerations for your own situation when it comes to getting or not getting these types of vaccines.”
With the potential of another “tripledemic” happening this flu season, it’s a good idea for those with eczema to start talking to their doctor today about the flu, COVID-19 and RSV vaccines.
1. U.S. Food & Drug Administration. FDA Approves First Respiratory Syncytial Virus (RSV) Vaccine. https://www.fda.gov/news-events/press-announcements/fda-approves-first-respiratory-syncytial-virus-rsv-vaccine May 3, 2023. Accessed August 11, 2023.
2. Centers for Disease Control and Prevention. Influenza: Flu Shot. https://www.cdc.gov/flu/prevent/flushot.htm August 25, 2022. Accessed August 11, 2023.
3. Centers for Disease Control and Prevention. COVID-19: Stay Up to Date with COVID-19 Vaccines. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html September 15, 2023. Accessed October 2, 2023.
4. Leasure AC, Cowper SE, McNiff J, Cohen JM. Generalized eczematous reactions to the Pfizer-BioNTech COVID-19 vaccine. J Eur Acad Dermatol Venereol. 2021;35(11):e716-e717. doi:10.1111/jdv.17494
5. Corbeddu M, Diociaiuti A, Vinci MR, et al. Transient cutaneous manifestations after administration of Pfizer-BioNTech COVID-19 Vaccine: an Italian single-centre case series. J Eur Acad Dermatol Venereol. 2021;35(8):e483-e485. doi:10.1111/jdv.17268