Severe Hepatocellular Liver Injury After COVID-19 Vaccination Without Autoimmune Hepatitis Features: A Case Series

Various vaccines were developed and administered to end the pandemic caused by the novel coronavirus diseases 2019 (COVID-19). These vaccines caused rare side effects not known during clinical trials. We report 2 cases of idiosyncratic drug-induced liver injury where the Pfizer BioNTech COVID-19 mRNA vaccine was administered. Both cases showed hepatocellular liver injury with negative autoimmune features on serology and histology and progressed to a protracted course of severe jaundice and pruritus before resolving without any immunosuppressants. We hope to raise awareness of possible rare side effects of the COVID-19 vaccine so that physicians can be vigilant.