Third COVID-19 vaccine dose reduces infection, critical disease risk in cirrhosis by 80%
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WASHINGTON — Patients with cirrhosis who received three doses of the COVID-19 mRNA vaccine, demonstrated an 80% reduced risk for SARS-COV-2 infection, symptomatic COVID-19, and moderate/severe/critical COVID-19, noted a presenter here.
“When the FDA approved the booster or a third dose of the [COVID-19] vaccine, they initially approved it for solid organ transplant recipients, patients on immunosuppressive medications and malignancies, and then subsequently it was extended to all adults,” Binu John, MD, chief of gastroenterology and hepatology at Miami VA Health System and associate professor at the University of Miami, said. “However, that is limited clinical data looking at the benefit of the third dose in patients with cirrhosis.”
In their retrospective cohort study, John and colleagues examined patients with cirrhosis who received two doses of COVID-19 mRNA vaccine (n=13,041) vs. three doses (n=13,041), between July 18, 2021 and February 11, 2022 when Delta (B.1.617.2) and Omicron (B.1.1.529) were the predominant variants.
The researchers aggregated outcomes as all cases with COVID-19, symptomatic COVD-19, with at least moderate COVID-19 or severe or critical COVID-19.
According to study results, compared to patients with cirrhosis who only received two doses of the COVID-19 mRNA vaccine, patients who received a third dose demonstrated an 80.7% reduction in COVID-19 (95% CI 39.2-89.1, P<0.001), an 80.4% reduction in symptomatic COVID-19, and an 80% reduction in moderate/severe or critical COVID-19 (95% CI 34.5-87.6%, P=0.005).
Additionally, patients who received a third dose demonstrated a 100% reduction in severe or critical COVID-19 (95% CI 99.2-100.0, P =0.01) and a 100% reduction in COVID-19-related death (95% CI 99.8-100.0, P=0.007).
“Given the 80% reduction in overall infection, as well as the 100% reduction in severe/critical COVID-19, our data suggest that the third dose can overcome vaccine hyporesponsiveness seen in patients with cirrhosis,” John said. “Compared to patients who received two doses of the COVID-19 vaccine, recipients of a third dose of COVID-19 vaccine were associated with an 80% reduction in SARS-COV-2 infection, an 80% reduction in symptomatic COVID-19, an 80% reduction in the moderate/severe/critical COVID-19, a 100% reduction in severe/critical COVID-19 and a 100% reduction in COVID-19-related death, with overall rates of severe/critical COVID-19 remaining low in both groups.”
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John B, et al. Abstract 8: Association of three vs. two doses of mRNA COVID-19 vaccines and SARS-COV-2 infection and severity among patients with cirrhosis. Presented at: The Liver Meeting; Nov. 4-8, 2022; Washington (hybrid).
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