Commentary: Vaccine Hesitancy and Access to Psoriasis Care in the COVID-19 Pandemic

Sudden pandemic situations are a significant threat to people with known chronic illnesses representing an additional unexpected burden. Those with limited psycho-social resources and lower resilience are more likely to withdraw from regular care and seek help or information. However, the high proportion of people with psoriasis having interrupted access to care (40.1%), as described in the report by Cook et al, is unexpected. Still, in this report, the data were collected from a multi-national survey (PsoProtectMe) in 89 countries worldwide on 802 patients with psoriasis. In addition, psoriasis patients having interrupted access to care had increased vaccine hesitancy, were more prevalent in non-white ethnic groups, had shorter disease duration, and were less likely to take systemic immunosuppressants.

It is important to note that the disruption of care can be bi-directional. The affected people stopped seeing their treating physicians, but physicians also canceled patients’ appointments. It is worth noting that younger people with psoriasis and more severe disease were more likely to discontinue care, and the rate of vaccine hesitancy was higher in this group. The authors did not speculate about factors driving this coincident finding. This may be due to greater engagement of younger people through social media, in which worries and concerns (e.g., a new type of vaccine, fear of adverse events, etc) are intensively discussed and amplified without direct physician’s input. However, and encouragingly, the rate of vaccine hesitancy, which was 8.3% in the entire patient population, seems low and provides evidence that stakeholders providing care in the different healthcare systems can get through to people with psoriasis.

As reported by Cook et al, these data help identify groups that need correct and unbiased information based on solid and accurate evidence-based medicine.