Vaccines provide stronger immunity against COVID-19 vs. infection in cirrhosis patients
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SAN DIEGO — Vaccine-induced immunity correlated with significantly greater protection against COVID-19 compared with infection-induced immunity in patients with cirrhosis, according to results presented at Digestive Disease Week 2022.
“Immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be infection- or vaccine-induced,” Binu V. John, MD, MPH, affiliate associate professor at the University of Miami Miller School of Medicine and chief of hepatology at the Bruce W. Carter VA Medical Center, told Healio. “Cirrhosis is associated with decreased response to vaccines, but whether there is decreased immunity after SARS-CoV-2 infection in unvaccinated patients with cirrhosis is unknown.”
In a retrospective study of patients with cirrhosis, John and colleagues compared 443 participants with infection-induced immunity with 1,329 participants with vaccine-induced immunity. Infection-induced patients had their first positive SARS-CoV-2 PCR between December 2020 and April 2021, while vaccine-induced patients were fully vaccinated with an mRNA vaccine and received their first dose during same period. A positive SARS-CoV-2 PCR more than 60 days after previous infection or vaccination served as the outcome.
Investigators monitored patients until outcome, death or November 2021 (the end of the study period) and used the NIH COVID-19 severity scale to classify COVID-19 cases as asymptomatic, mild, moderate, severe or critical illness. Groups were matched 1:3 with propensity score matching, and scores were calculated based on COVID-19 severity variables.
According to John, vaccine-induced immunity was associated with a 76% lower likelihood of developing COVID-19, a 68% lower likelihood of symptomatic COVID-19 and an 81% lower likelihood of severe or critical COVID-19, compared with infection-induced immunity. There were no differences reported between groups for moderate COVID-19 (adjusted OR = 0.31; 95% CI, 0.06-1.56).
“These findings suggest that in patients with cirrhosis, vaccination is not only safer but also a more effective way to acquire immunity against COVID-19, compared to ‘natural’ infection,” John said.
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John B, et al. Abstract 782. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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