Association of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis

Abstract

IMPORTANCE Two mRNA-based vaccines against coronavirus disease 2019 (COVID-19) were found to be highly efficacious in phase 3 clinical trials in the US. However, patients with chronic illnesses, including cirrhosis, were excluded from clinical trials. Patients with cirrhosis have immune dysregulation that is associated with vaccine hyporesponsiveness.OBJECTIVE To study the association of receipt of the Pfizer BNT162b2 mRNA or the Moderna mRNA-1273 vaccines in patients with cirrhosis compared with a propensity-matched control group of patients at similar risk of infection and severe disease from COVID-19. DESIGN, SETTING, AND PARTICIPANTSWe performed a retrospective cohort study of patients with cirrhosis who received at least 1 dose of a COVID-19 mRNA vaccine at the Veterans Health Administration. Patients who received at least 1 dose of the vaccine (n = 20 037) were propensity matched with 20 037 controls to assess the associations of vaccination with new COVID-19 infection and COVID-19 hospitalization and death.

COVID-19 Vaccine Acceptance among Liver Transplant Recipients

“…Thus, further data on efficacy to two doses of COVID-19 vaccine among the LT recipients may help reducing vaccination hesitancy in some residual hesitant. Considering patients with liver cirrhosis, recently published efficacy clinical data in a population of 20,000 cirrhotic patients (LT recipients were excluded) showed that mRNA vaccine administration was associated with an excellent reduction in COVID-19-related hospitalization or death [17].…”

Rheumatoid arthritis patients treated with Janus kinase inhibitors show reduced humoral immune responses following BNT162b2 vaccination

“…A few studies have also tested the efficacy of the mRNA-based vaccines in immunocompromised individuals and in individuals with dysregulated immune responses. For example, Binu et al have tested the effectiveness of the BNT162b2 COVID-19 vaccine in patients with cirrhosis, a chronic disease that is characterized by immune dysregulation and which was previously associated with vaccine hyporesponsiveness [ 11 ]. Despite the tendency of these individuals to demonstrate lower vaccine-responsiveness, the mRNA-based COVID vaccine seems to be protective in cirrhosis patients, and a significant reduction in COVID-19-related hospitalization or death was seen in these individuals [ 11 ].…”

“…For example, Binu et al have tested the effectiveness of the BNT162b2 COVID-19 vaccine in patients with cirrhosis, a chronic disease that is characterized by immune dysregulation and which was previously associated with vaccine hyporesponsiveness [ 11 ]. Despite the tendency of these individuals to demonstrate lower vaccine-responsiveness, the mRNA-based COVID vaccine seems to be protective in cirrhosis patients, and a significant reduction in COVID-19-related hospitalization or death was seen in these individuals [ 11 ]. An additional study evaluated the serologic status and safety of the BNT162b2 vaccine in patients receiving active treatment for cancer [ 12 ].…”

Coronavirus Disease 2019 and Liver Transplantation: Lessons from the First Year of the Pandemic

“…A large cohort of patients with cirrhosis from the Veterans Administration was recently studied who received at least 1 dose of the vaccine (n = 20,037) compared with 20,037 propensity-matched controls to assess the association between vaccination and new COVID-19 infection and COVID-19 hospitalization and death. (102) By 28 days after the initial dose, receipt of 1 dose of an mRNA vaccine was associated with a 64.8% reduction in COVID-19 infections and 100% protection against hospitalization or death due to COVID-19 infection. Receipt of a second dose was associated with a 78.6% reduction in COVID-19 infections and 100% reduction in COVID-19-related hospitalization or death after 7 days.…”