Third COVID-19 Jab May Be Needed for Patients With Advanced Liver Disease


The Pfizer COVID-19 vaccine confers low immunity on people with advanced liver disease, so a third booster shot may be needed, according to a research presented at the 2021 International Liver Congress in Geneva, Switzerland, which was held from June 23-26.


Rifaat Safadi

Rifaat Safadi, professor of medicine at the Hadassah-Hebrew University Hospital in Israel, presented the study at the meeting convened by the European Association for the Study of the Liver (EASL).

Older age and advanced liver disease are risk factors for a lower immune response to the Pfizer’s COVID-19 vaccine, Safadi reported, according to a press release.

Safadi and researchers analyzed 88 patients living with hepatic fibrosis who had received both doses of the Pfizer vaccine to assess their immune response. He found that older age and advanced fibrosis with decreased steatosis are risk factors for less robust immune response to the vaccine.

Safadi suggested that a third dose of the vaccine booster should be evaluated in populations with lower immune response, according to the statement.

“We are beginning to understand more clearly just how disproportionately COVID-19 is impacting on people living with liver-related diseases and the studies presented at (the International Liver Congress meeting) will advance our knowledge on multiple fronts — knowledge that can potentially help inform policy responses to the pandemic going forward,” said Philipp Newsome, general secretary of EASL and professor of experimental hepatology and director of the Centre for Liver Research at the University of Birmingham in the United Kingdom.

Other findings related to COVID-19 that were presented at the 2021 include:

  • Chronic liver disease increased the odds of COVID-19 death by 80%, according to French researchers. Overall, 8.7% patients diagnosed with chronic liver disease were admitted for COVID-19 in France in 2020 and 24.1% of them died, most (63.9%) after a liver-related complication, according to researchers at Cochin Hospital in Paris.
  • The researchers compared patients with chronic hepatitis B on the antiviral drug treatment tenofovir for Baraclude (entecavir) and found that although the incidence of COVID-19 in patients taking the medications was similar, patients taking Baraclude were more likely to have a severe case of COVID-19. Tenofovir reduced the risk of severe COVID-19 by sixfold, the researchers said. “TDF(tenofovir) seems to exert a protective effect in patients with CHB infected by COVID-19,” according to the press release.
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