Psoriasis in priority group for vaccine..

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www.gov.uk/government/publications/covid-19-vaccination-care-home-and-healthcare-settings-posters/covid-19-vaccination-first-phase-priority-groups

So on the conditions list for group 6, psoriasis is listed.
I have psoriasis and have never been told I’m
in the at risk group?!
Does anyone else know anything about this!

Just jumping on to say I think the list has been updated and I can't see Psoriasis on there anymore? The link below details the following:

• chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and severe asthma

• chronic heart disease (and vascular disease)

• chronic kidney disease

• chronic liver disease

• chronic neurological disease including epilepsy

• Down’s syndrome

• severe and profound learning disability

• diabetes

• solid organ, bone marrow and stem cell transplant recipients

• people with specific cancers

• immunosuppression due to disease or treatment

• asplenia and splenic dysfunction

• morbid obesity

• severe mental illness

www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-30-december-2020/joint-committee-on-vaccination-and-immunisation-advice-on-priority-groups-for-covid-19-vaccination-30-december-2020

Really not sure based on descriptions here if my knee pain is PsA. It isn't swollen or hot to the touch. The pain feels like it is right inside the knee joint and it is very clicky too.

Separate question does being on methotrexate push you into category 4 for the vaccine? I have been offered and felt reluctant due to Covid but would consider as feel a little safer to be on it if I was vaccinated.

Oh - it looks like psoriasis is no longer included on the list

@DrumsPleaseandTriangleToo

Really not sure based on descriptions here if my knee pain is PsA. It isn't swollen or hot to the touch. The pain feels like it is right inside the knee joint and it is very clicky too.

Separate question does being on methotrexate push you into category 4 for the vaccine? I have been offered and felt reluctant due to Covid but would consider as feel a little safer to be on it if I was vaccinated.

Methotrexate alone doesn't, no.

It's still on this one:

www.gov.uk/government/publications/covid-19-vaccination-care-home-and-healthcare-settings-posters/covid-19-vaccination-first-phase-priority-groups

@Bluegot might it will be covered under the group of immunosuppression though?

I confess I don't have psoriasis, but was following as I do have a neurological condition so was interested in what was included. Mine is a neurological movement disorder so not entirely clear, I've just e mailed both my GP and neurologist to ask if it would be covered.

Edwinbear- would we not come under

• immunosuppression due to disease or treatment?

That list no longer cites lupus or RA which have always been included before. Are they just using a catch all term?

But I don’t think immunosuppressive due to disease would include psoriasis. Unless you are on immunosuppressants drugs? Immunosuppressants due to disease would be for instance hiv?
I suppose we just don’t know

@DrumsPleaseandTriangleToo cross posted! Yes, I reckon it might, but might be worth an e mail to the GP to check? Also has the benefit of making sure medical records are up to date.

@Bluegot

But I don’t think immunosuppressive due to disease would include psoriasis. Unless you are on immunosuppressants drugs? Immunosuppressants due to disease would be for instance hiv? I suppose we just don’t know

Lots of people with moderate to severe psoriasis are on immune suppressing drugs, e.g. steroids, methotrexate, humira, ustekinamab, cyclosporine to name a few....

Are there even any non-immune suppressing meds for Psoraisis? Not sure. E.g. RA or Crohn's there are first line meds that are not significantly immune suppressing (mesalazines and sulphasalazines)

Certainly seems there is inconsistency between different versions of the advisory documents as to what conditions are included with and without immune suppressing medication

I think quite a lot of people would manage psoriasis just with creams not any tablets or anything? The creams wouldn’t be immunosuppressants?

I wonder if psoriasis ended up on the list cos someone somewhere assumed immunosuppressants drugs for all patients. But the actual condition itself doesn’t make someone more vulnerable

I dont think anyone with psoriasis would think it was just that to make you vulnerable they well I definitely knew its was the medication

@Justme123123

I dont think anyone with psoriasis would think it was just that to make you vulnerable they well I definitely knew its was the medication

I disagree - I think, based on what we now know of Covid, conditions like psoriasis which is basically an overactive immune system attacking the body are very similar in their impact hence why medication likely anti-TNFs which are used to treat psoriasis are also being used, successfully, to treat severe cases of covid. It's not really clear to me whether it's on the list or not at the moment but I can absolutely understand why it would be.

@Bluegot

I think quite a lot of people would manage psoriasis just with creams not any tablets or anything? The creams wouldn’t be immunosuppressants?

steroid creams are immune suppresants but as they are working locally they wouldn't fall under dangerously immune suppressing for the majority of users. Vitamin D creams and UV light are more likely immune regulating. This paper suggests 60% of sufferers need specialist input. Lots of immune suppresing drugs in the briefing www.nice.org.uk/guidance/qs40/documents/psoriasis-briefing-paper2

Topical steroid and Vit D ointments, creams and foams DO suppress immune responses at a cellular level - that's how they work. Obviously the effect is more localised than if the patient is injecting, say, a biologic like Adalimumab.

Take Enstilar foam, for example. Here's part of an official description:

"In addition, vitamin D has an immunomodulatory effect, suppressing activation and differentiation of Th17/Th1 cells while inducing a Th2/Treg response. In psoriasis, corticosteroids suppress the immune system, particularly pro-inflammatory cytokines and chemokines, thereby inhibiting T-cell activation."

Psoriasis is not just a skin rash. It's an autoimmune disease in its own right, and is frequently co-morbid with other autoimmune conditions. The treatments for moderate to severe psoriasis are designed to interfere with the immune irregularities, and these can then bring their own risks, e.g. increased susceptibility to infections.

It's unknown territory, throwing Covid-19 into the mix.

I've had psoriasis since I was 13 and it's a bastard.

@JamieLeesCurtains

Topical steroid and Vit D ointments, creams and foams DO suppress immune responses at a cellular level - that's how they work. Obviously the effect is more localised than if the patient is injecting, say, a biologic like Adalimumab.

Take Enstilar foam, for example. Here's part of an official description:

"In addition, vitamin D has an immunomodulatory effect, suppressing activation and differentiation of Th17/Th1 cells while inducing a Th2/Treg response. In psoriasis, corticosteroids suppress the immune system, particularly pro-inflammatory cytokines and chemokines, thereby inhibiting T-cell activation."

Psoriasis is not just a skin rash. It's an autoimmune disease in its own right, and is frequently co-morbid with other autoimmune conditions. The treatments for moderate to severe psoriasis are designed to interfere with the immune irregularities, and these can then bring their own risks, e.g. increased susceptibility to infections.

It's unknown territory, throwing Covid-19 into the mix.

I've had psoriasis since I was 13 and it's a bastard.

immune modulating is different from immune suppressing. That is why vitamin D, and probably vitamin A is in the mix there too as helpful but different in its mechanism of action (despite the failed class action on Accutane, many do experience gut inflammation on it so there is something going on with vitamin A and some good research emerging on its importance to the gut and immune system). As we know the meds that suppress flares of so called auto-immune diseases can have dreadful side effects, and also increase susceptibility to some cancers. Inflammation after all in the right dose does something good for the body too.

Many in the field are starting to use the term "immune mediated diseases" rather than "auto immune diseases" to try to highlight this difference. The holy grail in an immune system that is modulated to allow inflammation at a helpful level to the body where needed but not to create inflammation to the extent that it damages

Fascinating stuff, @time4anothername, and I appreciate you taking the time to post.

How would you categorise Hashimoto's? (I've got that too - occurred in my late 40s. Followed by IBS in my 50s. Bit of a nightmare really, on top of everything else.)

@JamieLeesCurtains

Fascinating stuff, *@time4anothername*, and I appreciate you taking the time to post.

How would you categorise Hashimoto's? (I've got that too - occurred in my late 40s. Followed by IBS in my 50s. Bit of a nightmare really, on top of everything else.)

Hashimotos is not one I've looked into. Sounds like you have a lot to manage. Gut bacteria is getting linked into all of these conditions too (e.g. pubmed.ncbi.nlm.nih.gov/30294759/ ), so keep an eye on the IBS that it doesn't develop into IBD.

The Green Book provides the detail on vaccinations and risk groups. Psoriasis isn’t there unless requiring the use of immunosuppressants I think. assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/948757/Greenbook_chapter_14a_v4.pdf

DH has psoriasis but hasn’t had any letter telling him to shield.

On the other side mil/fil are both 70’s, diabetics and have heart disease but still not been contacted for a vaccine.

Apologies if this has already been shared - it's q&a on the vaccine and psoriasis

https://www.psoriasis.org/watch-and-listen/covid-19-vaccine-q-and-a/?utmsource=National+Psoriasis+Foundation+-+Master+List&utmmcampaign=2fea3be58b-OURSPOTTEMAILCAMPAIGNN202101111COPYY01&utmmedium=email&utmmterm=0_02c374486c-2fea3be58b-182102589

I have moderate psoriasis, have done most of my life. It didn't occur to me it might be a problem re covid until about November last year when I signed up for a covid vaccine trial. I wasnt initially allowed to take part due to my psoriasis. The doctor sort of reassured me I wasnt at greater risk of covid than the general population.

But a few weeks later they opened up the study to patients with previously excluded conditions and I was allowed to take part.

I have psoriatic arthritis and take medication for it including methotrexate. My arthritis medication has actually cleared up my psoriasis.

My consultant and gp have both told me I am CV. I did originally get the CEV letters but gp says that it would be CV not CEV. It didn't stop the letters and online calls in lockdown 1 though.

I now also have high blood pressure and take two medications for that. From what I know from the gp that also makes me CV.

I caught covid in October which wasn't fun. Still recovering with some ongoing symptoms over 3 months later. My role in my school means I am currently working from home during this lockdown, but in September I was working across school teaching nearly 300 children a week - and then we wonder why I caught it 🤷‍♀️

I guess what I need to determine now is whether everything out together makes me cv or cev.

Psoriatic arthritis - regular flare ups
Psoriasis - cleared up since taking the medication for the arthritis so no longer active

Medication - sulphasalazine and methotrexate injections; steroid injections twice a year, as required

Also:
Hypertension - newly diagnosed following covid in October
Medication - two types though don't think they affect anything in terms of covid severity, etc. At the moment hypertension is still too high but dangerously so, hence a second teeing added this week.

Not sure if that keeps me in CV or CEV - doesn't make much difference day to day as school are happy with me working from home right now, and having had covid in October I'm hoping I may have a little bit more time with some immunity, though no one can guarantee that