Cirrhosis of the liver is the impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease.
It is associated with decreased responsiveness to most vaccines, including against COVID-19.
The disease is linked to decreased responsiveness to COVID-19 mRNA vaccines as evidenced by results after two doses.
In a study from the University of Miami, scientists strongly support giving the recommended booster vaccinations to these patients.
They examined over 26,000 patients with cirrhosis and found an 80% reduction in COVID-19 occurrence, a 100% reduction in severe or critical COVID-19, and a 100% reduction in COVID-19-related death.
The team previously demonstrated that in patients with cirrhosis, the effectiveness associated with two doses of an mRNA vaccine was lower and slower compared to that seen in a healthy population.
Patients with cirrhosis are particularly vulnerable to the impact of COVID-19, presenting higher hospitalization and mortality rates compared to those without liver disease.
In the current study, the team examined patients with cirrhosis who received two or three doses of either the Pfizer BNT162b2 mRNA or Moderna mRNA-1273 vaccines, when the delta and omicron variants were active.
Around 13,000 participants who received three doses of the vaccine were propensity-matched with 13,000 controls who had received two doses.
Patients who received three doses were evaluated for the development of COVID-19 and disease severity.
The team showed that the receipt of the third dose of either the BNT162b2 mRNA or the mRNA-1273 vaccines is linked to an 80% decrease in the development of COVID-19 and symptomatic COVID-19, and a 100% reduction in severe or critical COVID-19 and COVID-19—related death, compared to participants with cirrhosis who received only 2 doses.
They suggest that patients with cirrhosis should be encouraged to receive a third dose for adequate protection because it appears to be highly effective against severe outcomes of COVID-19.
This study suggests that the third dose of an mRNA vaccine can offer significant protection against COVID-19, particularly against severe disease.
The vaccine was observed to be protective in both patients with compensated cirrhosis (where the liver function is relatively preserved and patients have no symptoms of liver disease), and decompensated cirrhosis (when liver disease is worse and associated with symptoms), but the magnitude of reduction was greater in patients with compensated cirrhosis.
It adds to the growing body of evidence demonstrating the importance of COVID-19 vaccination in cirrhosis.
If you care about COVID, please read studies about antibodies that block all the COVID-19 variants, and vitamin D levels could determine the severity of COVID-19 infection.
For more information about COVID, please see recent studies about face masks that can capture and deactivate the COVID-19 virus, and results showing flu and COVID-19 vaccines may increase heart disease risk.
The study was conducted by Binu V. John et al and published in the Journal of Hepatology.
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