Vaccination and Lichen Sclerosus

I have had quite a few questions from my Lichen Sclerosus patients and some of my Instagram followers as well about the COVID-19 vaccination and can it affect Lichen Sclerosus (LS) and treatment. Questions such as - is it safe and will my LS flare. The information below relates to vaccinations available in Australia.

There are different types of vaccines for COVID-19. The ones in Australia are either based on viral vector DNA (Astra-Zeneca) or on mRNA (Pfizer and Moderna). These gene therapy-based vaccines produce an immune response which is predominantly the Th1-type response. This leads to high levels of cytokines which are like little emails that cells send to each other to communicate.

Basically, these vaccinations give instructions to our cells to tell them how to recognise the SARS-coV-2 (corona) virus which causes COVID-19 disease. It also halps the cells to better communicate with each other. It’s like they take a first aid course so they know what to do in an emergency. Without these vaccinations you’re body immune cells have to learn how to recognise the virus after you have been infected ‘on the go’ so to speak. By having the vaccination you save a bit of time - which can be the difference between a really nasty infection and a mild infection - because your body is primed and ready to go.

There is no evidence that the COVID-19 vaccinations flare Lichen Sclerosus - YAY!

If you are on an immunosuppressant agent then you may need to pause it (depending on which one you are on) when you get your vaccination so that the vaccination has a chance to prime your immune system. It is best to talk to your treating doctor if you are on these so that you can time your immunosuppressant dose. Don’t stop your treatment. The Australian Medical Dermatology Group advises to get the vaccine if you are on an immunomodulatory or biologic agent. They also state that there is no data that 1 vaccine is better than another.

If you are on prednisone (I have not needed to give prednisone for Lichen Sclerosus but anyway) then it is usually a very small dose such as 20mg daily or less. Vaccination is still recommended. Remember that there is no live virus in the vaccination.

In summary, I want to reassure you that the vaccinations that are available have not been found to flare Lichen Sclerosus. They can be given if you are on an immunosuppressive. The vaccine may be less effective if you are on an immunosuppressive - but a reduction is still better than no effectiveness of a vaccine - especially when it comes to COVID-19. I certainly wouldn’t want COVID-19!