Does Cosentyx Reduce COVID-19 Vaccine Protection?
Cosentyx (secukinumab), an IL-17 inhibitor for psoriasis and other autoimmune conditions, impairs immune responses to vaccines, including COVID-19 shots. Real-world data and studies show it lowers antibody levels post-vaccination, potentially reducing protection against SARS-CoV-2.[1][2]
Patients on Cosentyx produced fewer anti-spike antibodies after mRNA vaccines like Pfizer or Moderna compared to healthy controls. One study of 112 psoriasis patients found those on biologics like secukinumab had 40-50% lower seroconversion rates.[3] Neutralizing antibody titers also drop, though T-cell responses may hold up better.[4]
How Strong Is the Data on Interference?
Evidence comes from observational studies and small trials:
- A 2022 Italian study (n=82) reported Cosentyx users had median anti-spike IgG levels 3-5 times lower than non-biologic groups 4-6 weeks post-vaccination.[2]
- Larger psoriasis cohorts (e.g., 2023 meta-analysis) confirm biologics blunt humoral immunity by 20-60%, with IL-17 inhibitors like Cosentyx showing moderate effects versus TNF inhibitors (stronger suppression).[5]
No head-to-head RCTs exist specifically for Cosentyx and COVID vaccines, but patterns align with its mechanism: blocking IL-17 hampers B-cell activation and antibody production.[1]
Breakthrough infections occur more often in biologic users, though absolute risk depends on variants and boosters.[6]
Should You Skip or Time Vaccinations?
Guidelines recommend vaccinating anyway—benefits outweigh reduced efficacy. ACCP and BAD advise:
- Get inactivated or mRNA vaccines; live vaccines are contraindicated.
- Time doses: vaccinate before starting Cosentyx if possible, or during treatment without pausing (no strong evidence pausing boosts response).[7][8]
Boosters help restore antibodies in most cases.[4]
Consult your doctor; monitor titers if high-risk.
How Does Cosentyx Compare to Other Biologics?
| Biologic Class | Vaccine Antibody Reduction | Notes |
|---------------|-----------------------------|-------|
| IL-17 inhibitors (Cosentyx) | Moderate (30-50%) | T-cells less affected [3] |
| TNF inhibitors (Humira) | High (50-70%) | Strongest suppression [5] |
| IL-23 inhibitors (Tremfya) | Low-moderate (20-40%) | Better humoral response [9] |
| JAK inhibitors (Xeljanz) | Variable (10-50%) | Oral, faster recovery post-dose [6] |
Switching biologics pre-vaccination isn't routine but considered for poor responders.[7]
What About Boosters, Variants, or Long COVID?
Boosters (e.g., bivalent) improve titers even on Cosentyx, often matching healthy levels after 2-3 doses.[4] Omicron-era data shows persistent gaps against infection but protection against severe disease.[10]
No specific link to long COVID risk from vaccine interference, but underlying autoimmunity elevates baseline COVID severity.11
Sources:
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8662511/
[2]: https://pubmed.ncbi.nlm.nih.gov/35124858/
[3]: https://www.jidonline.org/article/S0022-202X(22)00045-2/fulltext
[4]: https://ard.bmj.com/content/82/5/620
[5]: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00002-5/fulltext
[6]: https://www.rheumatology.org/Portals/0/Files/COVID-19-Vaccine-Clinical-Guidance-Rheum-Health-Care-Providers.pdf
[7]: https://www.bad.org.uk/shared/get-file.ashx?id=391&itemtype=document
[8]: https://www.chestnet.org/Guidelines-and-Resources/COVID-19-Guidelines
[9]: https://pubmed.ncbi.nlm.nih.gov/35997502/
[10]: https://www.medrxiv.org/content/10.1101/2023.01.20.23284827v1