Immunogenicity, Effectiveness, and Safety of COVID-19 Vaccines among Patients with Immune-Mediated Dermatological Diseases: A Systematic Review and Meta-analysis

Immunocompromised individuals, primarily attributable to using immunosuppressants, face heightened COVID-19 risks. Despite the proven efficacy of COVID-19 vaccines, their impact on patients with immune -mediated dermatological diseases remains unclear. This study aims to thoroughly examine vaccine immunogenicity, effectiveness, and safety in immunemediated dermatological disease patients. Clinical studies in adults that compared vaccinated immune -mediated dermatological disease patients with vaccinated healthy controls or unvaccinated immune -mediated dermatological disease patients in terms of vaccine immunogenicity, COVID-19 infection, adverse events, or exacerbation of immune -mediated dermatological diseases were searched via electronic data bases. Seventeen studies (1,348,690 participants) were included. Seroconversion rates between immune -mediated dermatological disease patients and healthy controls were not different. However, among individuals aged <= 55 years, immune -mediated dermatological disease patients had lower mean anti-SARS-CoV-2 IgG levels. Immunosuppressed immune -mediated dermatological disease patients also had lower titres and were less likely to achieve T -cell response. In terms of safety, the risk of adverse events was higher in atopic dermatitis patients, but those with psoriasis had a reduced risk. Additionally, immunosuppressed patients had fewer adverse events. Vaccinated immune -mediated dermatological disease patients had a lower risk of COVID-19 infection than unvaccinated patients but a higher risk than healthy controls; however, disease exacerbation may be induced. In conclusion, immune -mediated dermatological diseases showed a reduced vaccine response in our meta -analysis, yet vaccination remained effective against COVID-19 infection and well tolerated. SIGNIFICANCE The lack of clarity on specific immunogenicity in patients with immune -mediated dermatological diseases despite their elevated risk of COVID-19 infection led to this study where a comprehensive review and analysis of vaccine effectiveness and safety was performed in this population, comparing the outcomes with healthy controls and unvaccinated immune -mediated dermatological diseases. The study found that while immune -mediated dermatological disease patients show a comparable overall immune response to COVID-19 vaccination as healthy controls, they have a lower risk of breakthrough infections and hospitalization than unvaccinated immune -mediated dermatological diseases. Vaccination appears to be effective and well -tolerated in preventing COVID-19 infection in immune -mediated dermatological disease patients.