Vaccinations

Having cirrhosis can make your immune system weaker and put you at higher risk of getting sick from viruses.

Vaccines can help lower your risk.

Below you can find information about some common vaccines you can consider. Ask your health care team which vaccines are right for you and how you can access them in your community.

COVID-19

Local availability and prioritization policies will affect when you may be eligible to receive the COVID-19 vaccine. People with cirrhosis should get the first COVID vaccine they are eligible for. If you have had infection or fever, you should wait to get vaccine until you are recovered.

For more information COVID-19 vaccine click here.

Until more data is available, below are some liver related COVID-19 vaccine recommendations. These are general, and may not apply to your specific health situation. Talk to your healthcare team to find out what is recommended for you.

Hepatitis B or C

If you are taking antiviral medications for Hepatitis B or C, you should NOT stop these medications while getting COVID-19 vaccines.

PBC and Autoimmune Hepatitis

If you take medication for primary biliary cholangitis (PBC) or autoimmune hepatitis, you should NOT stop these medications while getting COVID-19 vaccines.

Hepatocellular Carcinoma (HCC)

If you are being treated for HCC with ablation, embolization or chemotherapy, you should still be considered for COVID-19 vaccines without having to stop your HCC treatment

Liver Transplant Candidates

If you are waiting for liver transplant, you should get the COVID-19 vaccine, with the final dose given at least 1-2 weeks before transplant if possible.

Because liver transplant is considered a life-saving procedure, if you are offered a liver from a deceased donor, you should NOT delay your transplant because you recently received a COVID-19 vaccine.

Living Liver Donors

If you are wishing to donate part of your liver (live liver donor), you should get a COVID-19 vaccine. Your second dose should be at least two weeks before the transplant surgery if possible.

Liver Transplant Recipients

Always talk to your transplant team about COVID vaccine and your specific situation. Until more data is available, below are some considerations:

  • If you have received a liver transplant, COVID-19 vaccination is recommended for you.
  • Wait at least 1 month after transplant before getting the vaccine. 
  • Wait at least 1-month after treatment of rejection before getting the vaccine.
  • If you have had COVID, wait until your symptoms are gone and you are no longer considered infectious prior to vaccination.
  • Wait for a period of at least 2 weeks after the administration of another vaccine.
  • Your anti-rejection medications should NOT be lowered for the purpose of trying to increase your immune response to the vaccine.
  • If you are due for a second dose of vaccine right after your transplant, the second dose can be delayed to when will likely have a better immune response.
  • Your household contacts should be vaccinated whenever possible.

 Based on the AASLD Expert Panel Consensus Statement on Vaccines to Prevent COVID-19 Infection in Patients with Liver Disease

Influenza vaccine

If you have cirrhosis, you should get the influenza vaccine each year (usually available in the fall), to protect you against influenza viruses. This can usually be arranged through your family doctor or the public health clinic in your community. For more information, visit the links below:

What Difference Could the Flu Shot Make?

Influenza (FLU) vaccine

Common questions about influenza immunization

Pneumococcal Vaccine (Pneumovax)

If you have cirrhosis, you should get the pneumococcal vaccine to protect you against pneumococcal diseases. This can usually be arranged through your family doctor or the public health clinic in your community. For more information, visit the links below:

Pneumococcal Polysaccharide Vaccine FAQs

Pneumococcal polysaccharide (PNEUMO-P) vaccine

Hepatitis A & B Vaccines (Twinrix, Havrix)

Hepatitis A & B are viruses that can damage your liver. If you have cirrhosis, you should get vaccines to protect you against these viruses. This can usually be arranged through your family doctor or the public health clinic in your community. For more information, visit the links below:

Hepatitis A and B (HABV) vaccine

References:

The information on this page was adapted (with permission) from the references below, by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).

This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.

References: 

  1. US Department of Veterans Affairs, Veterans Health Administration 
  2. Canadian Liver Foundation
Last reviewed March 15, 2021
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