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Immunizations for People with Liver Disease

For patients with chronic liver disease, getting another acute disease such as hepatitis, influenza, or pneumococcal pneumonia may be more serious than for people without underlying liver disease. Therefore, immunization against these diseases is very important.

Patients with Hepatitis B, Hepatitis C, alcoholic liver disease, fatty liver disease, hemochromatosis, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis, Wilson’s disease, alpha one antitrypsin deficiency, or idiopathic cirrhosis should talk to their doctors about the following vaccinations:

Hepatitis A

Hepatitis A virus infection can vary in severity from a mild flu-like illness to severe liver inflammation and death. A person can become infected with Hepatitis A by consuming contaminated food or water or touching a contaminated surface. It is recommended that all patients with chronic liver disease be vaccinated against Hepatitis A. This is given as an injection followed by a booster dose 6-12 months after the first shot. The vaccine is well tolerated with minimal side effects. 95% of patients with liver disease who are vaccinated develop protective antibodies against Hepatitis A. There is no need to check post-immunization blood titers.

Hepatitis B

Hepatitis B virus can cause a chronic infection, which can lead to cirrhosis and/or liver cancer. It is transmitted by contact with an infected individual’s body fluids. It is recommended that all people with chronic liver disease be vaccinated against Hepatitis B. Three injections are given over 6 months. The vaccine is well tolerated with minimal side effects. The response to liver disease vaccinations is not as good as with the Hepatitis A vaccine. 94% of patients with fatty liver disease develop protective antibodies, however for other causes of chronic liver disease, the response is much lower. Therefore, some experts recommend testing for post-immunization Hepatitis B antibody titers in patients with chronic liver disease due to their risk of severe infection. If a patient has not responded to the vaccine, repeat liver disease immunizations with high-dose Hepatitis B vaccine may be considered.

Hepatitis C

There is currently no available Hepatitis C vaccine.


This is one of the most common causes of pneumonia. The pneumococcal vaccine is recommended for all adults with chronic liver disease regardless of age. This is a one-time injection. Immunization develops 2-3 weeks after the vaccination. This vaccine is well tolerated with minimal side effects.


This is commonly known as the flu. It is recommended that persons with chronic liver disease receive a yearly, seasonal flu shot. It is well tolerated with side effects in fewer than 5% of people.


There are no specific recommendations on the use of other vaccines (measles, mumps, rubella, diphtheria, tetanus, pertussis, herpes zoster) in people with chronic liver disease. However, herpes zoster immunization is recommended in persons 60 and older. And a routine diphtheria/tetanus booster immunization is recommended every 10 years.

Please contact the doctors at Granite Peaks Gastroenterology to discuss your liver disease immunizations needs.