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. 2022 Apr;18(4):196-206.

Optimizing Immunization Strategies in Adult Patients With Chronic Liver Disease and Liver Transplant Recipients

Stacey Rolak  1 , Adnan Said  2 , Rita German  2 , Mary S Hayney  3 , Freddy Caldera  2
Affiliations

Optimizing Immunization Strategies in Adult Patients With Chronic Liver Disease and Liver Transplant Recipients

Stacey Rolak et al. Gastroenterol Hepatol (N Y). 2022 Apr.

Abstract

Patients with chronic liver disease (CLD) and liver transplant recipients are at increased risk for infections from vaccine-preventable diseases. Gastroenterologists and hepatologists should assess patient immunization history, and necessary vaccinations should be given as soon as possible. Vaccines demonstrate superior immunogenicity when given earlier in the course of liver disease and prior to transplant. This article summarizes recommendations from the Advisory Committee on Immunization Practices for vaccinations in patients with CLD and liver transplant recipients, and includes a discussion of the influenza, herpes zoster, hepatitis A, hepatitis B, pneumococcal, human papillomavirus, and COVID-19 vaccines.

Keywords: Vaccines; liver diseases; liver transplantation; vaccine-preventable diseases.

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Figures

Figure 1.
Figure 1.
ACIP-recommended pneumococcal vaccine schedule for liver transplant recipients and patients with chronic liver disease who are immunosuppressed. ACIP, Advisory Committee on Immunization Practices; PCV13, pneumococcal conjugate 13-valent vaccine; PCV15, pneumococcal conjugate 15-valent vaccine; PCV20, pneumococcal conjugate 20-valent vaccine; PPSV23, pneumococcal polysaccharide 23-valent vaccine.
Figure 2.
Figure 2.
ACIP-recommended pneumococcal vaccine schedule for patients with chronic liver disease who are not immunosuppressed. ACIP, Advisory Committee on Immunization Practices; PCV13, pneumococcal conjugate 13-valent vaccine; PCV15, pneumococcal conjugate 15-valent vaccine; PCV20, pneumococcal conjugate 20-valent vaccine; PPSV23, pneumococcal polysaccharide 23-valent vaccine.
Figure 3.
Figure 3.
ACIP-recommended COVID-19 mRNA vaccine schedule. ACIP, Advisory Committee on Immunization Practices; mRNA, messenger RNA.
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