COVID-19 mRNA vaccines effective in patients with cirrhosis, study finds

US veterans with cirrhosis or liver damage who also received mRNA COVID-19[female[feminine vaccine has seen high levels of protection against hospitalizations and virus-related deaths, study finds.

The findings come as federal health officials have said the two groups of concerns regarding the potential use of booster doses include people 75 years of age and over and those with weakened immune systems, or immunocompromised patients. The authors of the study noted that “patients with cirrhosis exhibit immune dysregulation associated with hyporesponsiveness to the vaccine.” Ongoing research by the FDA and an expert panel at the CDC aims to determine if, when, and for whom booster shots may be needed. However, for now, the FDA and CDC have said that “Americans who have been fully vaccinated do not need a booster just yet,” citing highly effective vaccines.

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Researchers affiliated with Bruce W Carter VA Medical Center in Miami published results in JAMA Internal Medicine on Tuesday, from a retrospective study of 20,037 U.S. veterans with cirrhosis who received at least one dose of vaccine from the Veterans Health Administration, compared to 20,037 other matched controls. The researchers used national data from the Veterans Cohort and Costs Associated with Liver Disease (VOCAL) to conduct the study.

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The results suggest that vaccination with the Pfizer or Moderna vaccine reduced COVID-19 infections in patients by 64.8% and led to a 100% drop in hospitalizations or COVID-19-related deaths after 28 days. However, those whose liver function (or decompensated cirrhosis) deteriorated further saw less protection against COVID-19 infection compared to patients with compensated cirrhosis, or those in the asymptomatic stage at 50.3%. versus 66.8%, respectively, although a second dose increased protection against infection to 78.6%. The authors noted a “significant knowledge gap” regarding the efficacy of the vaccine in patients with cirrhosis, particularly those with a decompensated form of the disease.

Of note, vaccinated and unvaccinated patients faced a similar number of infections within 28 days of the first dose, although the benefits of vaccination were reported after 28 days.

Study patients were around 69 years old on average, and over 97% of individuals in each study group were male, 60.6% were Caucasian, believed to reflect a veteran population Americans, and the study included a “considerable proportion” of black patients. at 23.2%.

This cohort study of US veterans found that administration of mRNA vaccines was associated with a delayed but modest reduction in COVID-19 infection, but an excellent reduction in hospitalizations or COVID-related deaths -19 in patients with cirrhosis, ”the authors wrote.

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The study authors said that although patients with cirrhosis induce a limited response to other vaccines, injections of COVID-19 mRNA resulted in a reduction in coronavirus infections.