The pattern of injury on histology was consistent with acute hepatitis, with features of autoimmune hepatitis or possible drug-induced liver injury (DILI), triggering an autoimmune-like hepatitis. This case illustrates immune-mediated hepatitis secondary to the Moderna vaccine, which on inadvertent re-exposure led to worsening liver injury with deranged synthetic function. This occurred in a well man with no other medical problems. The onset of jaundice associated with the mRNA vaccine was unusually rapid. This was also illustrated in the other cases where symptoms developed over a median of 7 days (range 4-35). Latency is usually longer in other causes of DILI, but can vary depending on mode of injury. The mRNA vaccine pathway triggers pro-inflammatory cytokines including interferon and cross-reactivity has been illustrated between the antibodies against the spike protein and self-antigens.
https://www.journal-of-hepatology.eu/article/S0168-8278(21)02093-6/fulltext#