Many people living with Liver Disease have questions about the Covid-19 vaccine, including how effective it is and if there are any risks associated with it specifically related to Liver Disease. This article will attempt to summarize some of the publicly available information on vaccine efficacy and safety for those with Liver Disease. As always, you should consult with your doctor if you have specific questions or concerns.
Is the covid-19 vaccine safe?
Generally vaccines are safe even for those who have had liver transplants, and even for those taking immunosuppressants. The CDC recommends that patients with Liver Disease are fully vaccinated for all available and relevant diseases. There is limited data specifically regarding Covid-19 vaccines and Liver Disease, with only a handful of patients enrolled in the various trials having advanced forms of Liver Disease.
However, there is universal agreement among medical professionals that patients with all forms of Liver Disease should be prioritized for the Covid-19 vaccine, due to their higher risk of serious illness or death from the disease. This is especially true for those with Liver Disease that are also overweight or obese, as obesity has proven to be the top comorbidity for hospitalizations and death, with a recent study showing nearly eighty percent of hospitalized patients were overweight or obese. As we know from NAFLD and NASH, weight and especially visceral obesity is a major factor in Liver Disease that appears to make patients especially vulnerable.
Patient advocacy groups also agree that vaccination should be a priority. The American Association for the Study of Liver Diseases (AASLD) and American Liver Foundation (ALF) both have issued strong recommendations for vaccination, with the former organization releasing a lengthy expert panel consensus statement which is well worth reading.
Of people who have been hospitalized, needed a ventilator or died from Covid-19, 27.8% were overweight and 50.2% were obese.
Body Mass Index and Risk for COVID-19 – CDC
IS the covid-19 vaccine effective?
Historically, most vaccines have decreased efficacy for patients with advanced Liver Disease, including cirrhosis and/or liver transplant. This is thought to be similar to the immune system deficiencies common among such patients, which is generally known as cirrhosis-associated immune dysfunction (CAID). There is growing evidence that such immune response impairment might be closely linked to severe Covid-19 outcomes among these patients.
While the effectiveness is extremely high in general, there is little data regarding efficacy of the various Covid-19 vaccines specifically in patients with Liver Disease. However, even with the chance of reduced effectiveness of the Covid-19 vaccines, medical professionals strongly recommend prioritization for immunization. Patients with Liver Disease are at high risk for severe outcomes from Covid-19 and should take any chance to reduce their risk.
“Given the high COVID-19-related mortality in patients with decompensated cirrhosis, it remains of utmost importance to prioritize vaccination in this subgroup.”
SARS-CoV-2 vaccination in patients with liver disease – The Lancet
Additionally, experts suggest that patients with Liver Disease should continue to take precautions even after fully vaccinated, due to the higher risk of severe outcomes and the potential for vaccine efficacy to be less than optimal.
If you have Liver Disease, you are already eligible for Covid-19 vaccine in all 50 states. You should strongly consider getting vaccinated as soon as possible.
David thank you for this jam packed informational email/blog! Liver disease and covid-19 information is so very important now for many more people than most of us realize. Good post.