Cirrhosis has been associated with decreased responsiveness to several vaccines. In a retrospective study of 26,082 patients with cirrhosis, participants who received three doses of a coronavirus disease 2019 (COVID-19) mRNA vaccine when Delta and Omicron were the predominant variants had an 80.7% reduction in COVID-19 incidence (95% CI 39.2–89.1, P < 0.001) compared with matched controls who only received two doses.