Patients with cirrhosis are vulnerable to hepatic decompensation events and death
following COVID-19 infection. Therefore, primary vaccination with COVID-19 vaccines
is fundamental to reducing the risk of COVID-19 related deaths in patients with cirrhosis.
However, limited data are available about the effectiveness of mRNA vaccines compared
to other vaccines. The aim of our study was to investigate the efficacy of mRNA vaccines
versus other vaccines in cirrhosis. In this retrospective study, we compared clinical
characteristics and vaccine effectiveness of 399 COVID-19 patients without cirrhosis
(GROUP A) to 52 COVID-19 patients with cirrhosis (GROUP B). 54 hospitalised cirrhosis
controls without COVID-19 (GROUP C) were randomly sampled 1:1 and matched by gender
and age. Of the cirrhosis cases, we found no difference (p = 0.76) in mortality rates
in controls without COVID-19 (11.8%) compared to those with COVID-19 (9.6%). However,
COVID-19 patients with cirrhosis were associated with higher rates of worsening hepatic
encephalopathy, ascites and esophageal varices. Patients with cirrhosis receiving
mRNA vaccines had significantly better survival rates compared to viral vector or
inactivated vaccines. Primary vaccination with the BNT162b2 vaccine was the most effective
in preventing acute hepatic decompensating events, COVID-19 infection requiring hospital
admission and in-hospital mortality.
