Journal of Hepatology: 'Among 470,274 individuals in the vaccine-exposed cohort, 177 individuals (0.038%) met liver injury criteria after SARS-CoV-2 vaccination. Sixty percent were female, 90% White and average age at first vaccine was 70 years. The frequency of liver injury after vaccine was no different between mRNA and viral-vector vaccines (0.038% vs. 0.024%, p = 0.26). Liver injury was observed after the first dose in 14% and second dose in 86%. Average time to injury after the first dose was 29 ± 21 days and second was 45 ± 25 days. Liver injury pattern was hepatocellular in 45%, cholestatic in 35%, and mixed in 20%. Peak mean for AST, ALT, ALP and TB were 800 IU/L, 553 IU/L, 405 IU/L, and 3.1 mg/dl, respectively. 29% of patients ever had TB >2.5 mg/dl. Follow-up liver biochemistries were available in 42 patients with liver injury after vaccination and liver tests normalized in 48% of them (defined as serum ALT <45 U/L, ALP <250 U/L and TB <2.5 mg/dl). Mean duration between first abnormal to first normal TB was 8 ± 14 days. Compared to influenza control, SARS-CoV-2 vaccination was associated with a lower frequency of liver injury after vaccination (0.038% vs. 0.069%, p = 0.04) (Table 1).'