Third dose of COVID-19 mRNA vaccine appears to overcome vaccine hyporesponsiveness in patients with cirrhosis

Cirrhosis is associated with immune dysregulation and hyporesponsiveness to several vaccines including those against COVID-19. Our aim was to compare outcomes between patients with cirrhosis who received 3 doses of either the Pfizer BNT162b2 mRNA or Moderna mRNA-1273 vaccines to a propensity-matched...

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Published in:Journal of hepatology 2022-11, Vol.77 (5), p.1349-1358
Main Authors: John, Binu V., Ferreira, Raphaella D., Doshi, Akash, Kaplan, David E., Taddei, Tamar H., Spector, Seth A., Paulus, Elizabeth, Deng, Yangyang, Bastaich, Dustin, Dahman, Bassam
Format: Article
Language:English
Subjects:
BNT162 Vaccine
BNT162b2 mRNA
booster dose
chronic liver disease
COVID-19 - epidemiology
COVID-19 - prevention & control
COVID-19 vaccines
COVID-19 Vaccines - adverse effects
hepatic decompensation
Humans
Liver Cirrhosis - complications
mRNA Vaccines
mRNA-1273
Retrospective Studies
SARS-CoV-2
Vaccines
Vaccines, Synthetic
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Summary:Cirrhosis is associated with immune dysregulation and hyporesponsiveness to several vaccines including those against COVID-19. Our aim was to compare outcomes between patients with cirrhosis who received 3 doses of either the Pfizer BNT162b2 mRNA or Moderna mRNA-1273 vaccines to a propensity-matched control group of patients at similar risk of infection who received 2 doses. This was a retrospective cohort study of patients with cirrhosis who received 2 or 3 doses of a COVID-19 mRNA vaccine at the Veterans Health Administration. Participants who received 3 doses of the vaccine (n = 13,041) were propensity score matched with 13,041 controls who received 2 doses, and studied between July 18, 2021 and February 11, 2022, when B.1.617.2 (delta) and B.1.1.529 (omicron) were the predominant variants. Outcomes were aggregated as all cases with COVID-19, symptomatic COVD-19, with at least moderate COVID-19, or severe or critical COVID-19. Receipt of the third dose of a COVID-19 mRNA vaccine was associated with an 80.7% reduction in COVID-19 (95% CI 39.2-89.1, p
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2022.07.036