{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T10:01:13Z","timestamp":1771754473450,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cantonal Hospital St. Gallen","award":["23\/26"],"award-info":[{"award-number":["23\/26"]}]},{"name":"Cantonal Hospital St. Gallen","award":["101003480-CORESMA"],"award-info":[{"award-number":["101003480-CORESMA"]}]},{"name":"Cantonal Hospital St. Gallen","award":["FKZ-3-4332.62-NMI-67"],"award-info":[{"award-number":["FKZ-3-4332.62-NMI-67"]}]},{"name":"Cantonal Hospital St. Gallen","award":["FKZ 3-4332.62-NMI-68"],"award-info":[{"award-number":["FKZ 3-4332.62-NMI-68"]}]},{"name":"Horizon Europe European Research Council","award":["23\/26"],"award-info":[{"award-number":["23\/26"]}]},{"name":"Horizon Europe European Research Council","award":["101003480-CORESMA"],"award-info":[{"award-number":["101003480-CORESMA"]}]},{"name":"Horizon Europe European Research Council","award":["FKZ-3-4332.62-NMI-67"],"award-info":[{"award-number":["FKZ-3-4332.62-NMI-67"]}]},{"name":"Horizon Europe European Research Council","award":["FKZ 3-4332.62-NMI-68"],"award-info":[{"award-number":["FKZ 3-4332.62-NMI-68"]}]},{"name":"State Ministry of Baden-W\u00fcrttemberg for Economic Affairs, Labor Tourism","award":["23\/26"],"award-info":[{"award-number":["23\/26"]}]},{"name":"State Ministry of Baden-W\u00fcrttemberg for Economic Affairs, Labor Tourism","award":["101003480-CORESMA"],"award-info":[{"award-number":["101003480-CORESMA"]}]},{"name":"State Ministry of Baden-W\u00fcrttemberg for Economic Affairs, Labor Tourism","award":["FKZ-3-4332.62-NMI-67"],"award-info":[{"award-number":["FKZ-3-4332.62-NMI-67"]}]},{"name":"State Ministry of Baden-W\u00fcrttemberg for Economic Affairs, Labor Tourism","award":["FKZ 3-4332.62-NMI-68"],"award-info":[{"award-number":["FKZ 3-4332.62-NMI-68"]}]},{"name":"University of Oxford","award":["23\/26"],"award-info":[{"award-number":["23\/26"]}]},{"name":"University of Oxford","award":["101003480-CORESMA"],"award-info":[{"award-number":["101003480-CORESMA"]}]},{"name":"University of Oxford","award":["FKZ-3-4332.62-NMI-67"],"award-info":[{"award-number":["FKZ-3-4332.62-NMI-67"]}]},{"name":"University of Oxford","award":["FKZ 3-4332.62-NMI-68"],"award-info":[{"award-number":["FKZ 3-4332.62-NMI-68"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Patients with chronic liver disease (CLD) have impaired vaccine immunogenicity and an excess risk of severe COVID-19. While variant-adapted COVID-19 mRNA vaccines are recommended for vulnerable individuals, their efficacy in patients with CLD has not been studied. Methods: We present the first evaluation of XBB.1.5 COVID-19 vaccine immunogenicity against the SARS-CoV-2 JN.1 variant in patients with CLD. Serum anti-receptor binding domain (RBD) IgG, neutralization, and saliva anti-RBD IgG and IgA against wild-type SARS-CoV-2 (WT) and the XBB.1.5, EG.5.1, BA.2.86, and JN.1 variants were quantified before and 2\u20134 weeks following a fourth dose of XBB.1.5 mRNA vaccines. Results: Vaccination boosted anti-RBD IgG and neutralization against all tested variants including JN.1 (each p &lt; 0.001). Following immunization, neutralization was lower against JN.1 compared to WT, XBB.1.5, and EG.5.1 (p &lt; 0.001, p &lt; 0.001, and p &lt; 0.01, respectively). Vaccination reduced neutralization failure rates against BA.2.86 and JN.1 (each p &lt; 0.05). The evasion of vaccine-induced antibodies by the tested variants was low, indicated by the positive correlation between anti-RBD IgG and neutralization. At mucosal sites, vaccination boosted anti-RBD IgG (each p &lt; 0.01) but failed to induce infection-blocking IgA (each p &gt; 0.05). Conclusion: XBB.1.5 vaccines protect CLD patients against recent SARS-CoV-2 variants, but developing vaccines with optimized mucosal immunogenicity is required to prevent SARS-CoV-2 transmission and recurrent seasonal COVID-19 outbreaks.<\/jats:p>","DOI":"10.3390\/vaccines12111241","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T06:55:37Z","timestamp":1730357737000},"page":"1241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["STAR LIGHT Study: XBB.1.5 COVID-19 mRNA Vaccines Boost Systemic but Not Mucosal Immunity Against the SARS-CoV-2 JN.1 Variant in Patients with Chronic Liver Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2528-0582","authenticated-orcid":false,"given":"Simon","family":"Woelfel","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"},{"name":"Max von Pettenkofer Institute of Hygiene and Medical Microbiology, Faculty of Medicine, Ludwig Maximilian University (LMU), 80336 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Junker","sequence":"additional","affiliation":[{"name":"NMI Natural and Medical Sciences Institute at the University of T\u00fcbingen, 72770 Reutlingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Bergamin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Meyer-Herbon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Stillhard","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5527-5365","authenticated-orcid":false,"given":"Nicole","family":"Graf","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Leinenkugel","sequence":"additional","affiliation":[{"name":"University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital of Basel, 4002 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"D\u00fctschler","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"},{"name":"Outpatient Clinic, Ambulatory Services Rorschach, 9400 Rorschach, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Kammerlander","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahel","family":"H\u00e4uptle","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, 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Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3133-0887","authenticated-orcid":false,"given":"Katline","family":"Metzger-Peter","sequence":"additional","affiliation":[{"name":"University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital of Basel, 4002 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Frei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"STAR SIGN Study Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0607-7159","authenticated-orcid":false,"given":"Werner C.","family":"Albrich","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology and Liver Unit, Nuffield Department of Medicine, University of Oxford, Oxford OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Bernsmeier","sequence":"additional","affiliation":[{"name":"University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital of Basel, 4002 Basel, Switzerland"},{"name":"Gastroenterology Group, Department of Biomedicine, University of Basel, 4031 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6902-5650","authenticated-orcid":false,"given":"Jan Hendrik","family":"Niess","sequence":"additional","affiliation":[{"name":"University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital of Basel, 4002 Basel, Switzerland"},{"name":"Gastroenterology Group, Department of Biomedicine, University of Basel, 4031 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Korte","sequence":"additional","affiliation":[{"name":"Center for Laboratory Medicine, 9001 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justus J.","family":"B\u00fcrgi","sequence":"additional","affiliation":[{"name":"Center for Laboratory Medicine, 9001 St. Gallen, 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