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Alukal JJ, Naqvi HA, Thuluvath PJ. Vaccination in Chronic Liver Disease: An Update. J Clin Exp Hepatol. 2021;doi: 10.1016/j.jceh.2021.12.003.
Alukal, J. J., Naqvi, H. A., & Thuluvath, P. J. (2021). Vaccination in Chronic Liver Disease: An Update. Journal of clinical and experimental hepatology, . https://doi.org/10.1016/j.jceh.2021.12.003
Alukal, Joseph J, et al. "Vaccination in Chronic Liver Disease: An Update." Journal of clinical and experimental hepatology vol. (2021). doi: https://doi.org/10.1016/j.jceh.2021.12.003
Alukal JJ, Naqvi HA, Thuluvath PJ. Vaccination in Chronic Liver Disease: An Update. J Clin Exp Hepatol. 2021 Dec 08; doi: 10.1016/j.jceh.2021.12.003. Epub 2021 Dec 08. PMID: 34975241; PMCID: PMC8710401.
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J Clin Exp Hepatol. 2021 Dec 08; doi: 10.1016/j.jceh.2021.12.003. Epub 2021 Dec 08.

Vaccination in Chronic Liver Disease: An Update.

Journal of clinical and experimental hepatology

Joseph J Alukal, Haider A Naqvi, Paul J Thuluvath

Affiliations

  1. Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore MD, USA.
  2. Medstar Health, Baltimore, USA.
  3. Department of Medicine, University of Maryland School of Medicine, Baltimore MD, USA.

PMID: 34975241 PMCID: PMC8710401 DOI: 10.1016/j.jceh.2021.12.003

Abstract

Patients with chronic liver disease (CLD) with or without cirrhosis remain at risk of developing hepatic decompensation when infected with viral or bacterial pathogens. The Advisory Committee on Immunization Practices (ACIP) currently recommends vaccination in CLD against hepatitis A virus (HAV), hepatitis B virus (HBV), influenza, pneumococcus, herpes zoster, tetanus, diphtheria, pertussis, and SARS-CoV-2. Inactivated vaccines are preferred over live attenuated ones, especially in transplant recipients where live vaccines are contraindicated. As the severity of the liver disease progresses, vaccine efficacy declines, and therefore, vaccines should be ideally administered early in the disease course for optimal immune response. Despite the strong recommendations, overall vaccination coverage in CLD remains poor; however, it is encouraging to note that in recent years coverage against influenza and pneumococcus has shown some improvement. Inadequate access to healthcare, lack of information on vaccine safety, poor financial reimbursement for healthcare providers, and vaccine misinformation are often responsible for low immunization rates. This review summarizes the impact of vaccine-preventable illness in those with CLD, updated vaccine guidelines, seroconversion rates in the vaccinated, and barriers faced by healthcare professionals in immunizing those with liver disease.

© 2021 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.

Keywords: ACIP, Advisory Committee on Immunization Practices; ACLF, acute on chronic liver failure; ALD, alcohol-related liver disease; CLD, Chronic liver disease; CLIF-C, Chronic Liver Failure Consortium; DAA, direct-acting antiviral drugs; HAV, hepatitis A virus; HBV, hepatitis B virus; HCV, hepatitis C virus; LT, liver transplant; NAFLD, nonalcoholic fatty liver disease; SARS-CoV-2; SOFA, sequential organ failure assessment; chronic liver disease; immunization; vaccines

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