Megan Noe, MD, MPH: Navigating COVID-19 Vaccines, Boosters with the Immunocompromised

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Three years into the pandemic, dermatologists have become more confident in discussing vaccine issues with their patients, including the misunderstood risk of disease flare-up associated with boosters.

Three years since the beginning of COVID-19, the discussion of benefit-risk data and long-term understanding of available vaccines remains a conversation among many laypeople and chronically ill patients at a potentially heightened risk of disease from the pandemic virus.

In dermatology, where many common conditions are now frequently managed with immunosuppressant therapy, there seems to be an improving alignment between patient and clinician interests around COVID-19 vaccination.

In the second segment of an interview with HCPLive during the American Academy of Dermatology (AAD) 2023 Annual Meeting in New Orleans this weekend, Megan Noe, MD, MPH, assistant professor of dermatology at Harvard Medical School, discussed the disparate interest in continuing the recommended COVID-19 vaccine booster regimen between the general population and her patients.

“I think most of my patients, especially those who are on an immunosuppressant medication, are concerned about their risk of infection and they are interested in the booster,” Noe said.

Noe acknowledged the frequent concern regarding the risk of skin disease flare associated with COVID-19 vaccines, noting its often the primary driver of hesitation among eligible patients who may not understand the full scope of evidence behind the risk.

“We have done some qualitative studies trying to understand how dermatology patients think about and make decisions about vaccines, and it seems like flaring in their underlying skin disease is a major concern for patients, so it’s always something I want to discuss,” Noe said. “It’s a conversation I have a lot, just to reassure patients we have more and more data about the safety, and the benefits of the vaccines really outweigh any small risk of having a little flare-up.”

Empathizing with patients’ sense of worry when encountering the choice to receive vaccination only years into its existence, Noe reflected how dermatologists had little to no experience navigating patient vaccination discussions in early 2020—now it’s a common practice across the field.

“And I think that’s good,” she said. “I think for patients who are seeing dermatologists for a chronic skin disease, they should trust their dermatologist for not only information about their skin but for their overall health.”