• The Centers for Disease Control and Prevention (CDC) has approved a second COVID-19 booster shot of the messenger RNA (mRNA) vaccines for people over 50 years old and those who are immunocompromised.
• The National Eczema Association advises individuals with eczema to talk with their health care providers about whether to receive a booster shot.

The CDC and U.S. Food and Drug Administration (FDA) have authorized and recommended a second COVID-19 booster shot for people 50 and over and those with immunocompromising conditions.

The National Eczema Association recommends that people with eczema (a condition also referred to as atopic dermatitis) share the decision-making with their doctors about whether to get a second booster shot against COVID-19, particularly since some eczema treatments should be timed around the vaccination.

The New Recommendations

Some important details about these recommendations include the following:

• This booster is for people who received their first booster at least four months ago.
• This fourth shot would be of either the Moderna or Pfizer vaccine, not the Johnson & Johnson vaccine.
• Even if you were previously vaccinated with the Johnson & Johnson vaccine, it is now recommended that this next dose be a Moderna or Pfizer vaccine only.
• For those who are immunocompromised and received a three-dose primary vaccination followed by an initial booster, this additional booster counts as a fifth shot.

How Booster Shots Can Protect People With Eczema

If you already had your first booster shot, you may be wondering what dermatologists say about whether additional boosters are effective for people with eczema. The National Eczema Association advises individuals with eczema to speak with their providers about whether to get a second booster shot and, if they do get one, how to time inoculation around eczema therapies.

Some medications for treating eczema, such as oral steroids, methotrexate, and Janus kinase (JAK) inhibitors, can compromise your immune system. It’s important to talk with your doctor about timing these medications around your booster shot, since some physicians advise waiting several days or weeks after getting the COVID-19 vaccine before taking methotrexate. However, this is a decision you must make in partnership with your health care provider.

The CDC’s list of underlying medical conditions doesn’t explicitly mention eczema as a condition that may qualify someone for a second booster shot. The list of underlying conditions includes, for example, chronic lung disease, diabetes, heart conditions, obesity, smoking or smoking history, and HIV infection.

“Just got my COVID vaccine booster dose, and I feel fine,” wrote one MyEczemaTeam member. Another said, “Had my two booster shots!”

Talk with your doctor if you have questions about your eligibility for an additional COVID-19 vaccine dose.

Why Booster Shots Matter

Research indicates that antibody levels are likely to decrease over time, so getting booster doses at recommended intervals is necessary — even for vaccinated people who made antibodies after their initial shots.

Simply making antibodies does not always translate to complete immunity from COVID-19 infection. The findings from recent studies, however, are promising. In one study of immunocompromised people with cancer, researchers tested levels of antibodies (proteins that the immune system makes to help destroy a target). In this case, the antibodies were to SARS-CoV-2 (the virus that causes COVID-19), made in response to the Moderna COVID-19 vaccine.

On average, antibodies against the coronavirus were identified after the second vaccine dose in about 90 percent of the study’s 515 participants. These results are considered a good sign that vaccines using mRNA — which include those by Moderna and Pfizer — for COVID-19 can trigger strong responses, even in people with compromised immune systems. It’s evidence that vaccines can protect people at higher risk of severe infections.

Although some people with eczema have expressed concern about experiencing a flare after vaccination, research indicates that this is rare. One study of 480 individuals with eczema who were being treated with dupilumab (Dupixent) found that just 2.7 percent of participants developed a worsening of symptoms following vaccination for COVID-19. All those cases were effectively treated within about 10 days following the flare-up.

According to the CDC, getting vaccinated is still the best way to protect yourself and slow the spread of the virus. If you are unvaccinated due to immunodeficiency, an autoimmune disease, or cancer treatment or because you are an organ transplant recipient, this new research should give you confidence to speak with your health care provider about when a COVID-19 vaccine would be right for you.

Find Your Team

On MyEczemaTeam, the social support network for people with eczema and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand.

Are you considering getting a second booster shot? Have you discussed any concerns with your health care provider? Share your insights in the comments below, or start a conversation by posting on your Activities page.