Taking cognizance of the risks associated with COVID-19, vaccine, and treatment in liver transplant recipients – A commentary on “The urgency of the Covid-19 vaccine in liver transplantation patients: What, how, and when?” [Int. J. Surg. 100 (Suppl) (2022) 106492)]

With immense interest, we read the publication by Hottua et al. on how COVID-19 vaccination is pivotal in averting early mortality and disease repercussions in liver transplant (LT) recipients [1]. The authors underscored based on the report by Fraser et al. (2020) that COVID-19 was associated with a mortality rate of 19.3% in LT recipients [2]. However, a multi-centric study based on the ELITA-ELTR COVID-19
Registry revealed that the mortality rate of COVID-19 positive LT recipients was strikingly higher – the overall mortality rate was 32.7% and reached 49.2% in subjects with decompensated cirrhosis [3]. In this line, John et al. demonstrated that fully vaccinated LT candidates (those who
received two doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer- BioNTech) vaccine) presented a 64% reduction in COVID-19 infection, 58% reduction in symptomatic COVID-19 and an 87% decrease in COVID-19–associated mortality [4]. Another study showed that receipt of three doses of the BNT162b2 (mRNA) vaccine increased the seropositive
rate, prevented the occurrence of COVID-19 infection, and did not cause any serious adverse events in all the solid-organ transplant recipients (SOTR) [5]. An update published on July 11, 2022 on the global COVID vaccination tracker (https://www.nytimes.com/intera ctive/2021/world/covid-vaccinations-tracker.html) showed that 2.13 billion additional doses were given worldwide as compared to 5.26
billion people (68.5%) who had received at least one dose of a COVID-19 vaccine [6].