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. 2023 Apr 26;5(8):100776. doi: 10.1016/j.jhepr.2023.100776

Table 1.

Recommended immunization schedule in patients with CLD or LT recipients.

Vaccine Liver transplant recipients Patients with chronic liver disease
Hepatitis B All patients should receive:
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    2-dose Heplisav-B 4 weeks apart, or

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    3-dose Engerix-B, Recombivax-HB or Twinrix at 0, 1 and 6 months
Hepatitis A All patients in Europe and United States should receive:
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    2 doses of Havrix 6 to 12 months apart, or

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    Vaqta 6 to 18 months apart, or

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    3 doses of Twinrix at 0, 1 and 6 months
Pneumococcal All patients should receive 1 dose of PCV13 followed by 3 doses of PPSV23 at:
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    ≥8 weeks after PCV13,

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    ≥5 years after the previous,

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    when they turn 65 years (≥5 years apart from the second PPSV23 dose)

 Patients between 19-64 years should receive 1 dose of PPSV23.
Patients >64 years should receive 1 dose of PPSV23 at least 1 or 5 years after PCV13 or PPSV23, respectively
Influenza inactivated Adult patients should receive 1 dose annually
Zoster live attenuated (Zostavax) Not recommended Vaccination might be indicated if benefit of protection outweighs risk of adverse reaction in specific patient
Zoster recombinant (Shingrix) Not recommended. If given, it should be administered before LT Patients ≥50 years should receive 2 doses 2-6 months apart, regardless of previous herpes zoster or history of zoster live vaccine
Tetanus, diphtheria and pertussis All patients should receive 1 dose of Tdap, then Td or Tdap booster every 10 years
Measles, mumps and rubella Not recommended. It should be given before LT Patients with no evidence of immunity and born in 1957 or later should receive 1 or 2 dose(s) depending on indication
Human papillomavirus All patients should receive 3 doses through age 26 Adult patients should receive 2 or 3 doses through age 26 depending on age at initial vaccination
Meningococcal ACWY and B Recommended for adults with an additional risk factor/indication, e.g. anatomical or functional asplenia, haematopoietic stem cell transplant or other additional factors
Haemophilus influenzae Recommended for adults with an additional risk factor/indication, e.g. anatomical or functional asplenia, haematopoietic stem cell transplant or other additional factors
COVID-19 vaccine Adult patients should receive:
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    3 doses of Pfizer-BioNTech mRNA, or

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    3 doses of Moderna mRNA, or

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    2 doses of Novavax Adjuvanted, or

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    1 dose of Janssen Adenoviral vector followed by mRNA vaccine; all followed by booster dose of mRNA vaccines ≥2 months after primary series

 Adult patients should receive:
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    2 doses of Pfizer-BioNTech mRNA, or

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    2 doses of Moderna mRNA, or

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    2 doses of Novavax Adjuvanted, or

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    1 dose of Janssen Adenoviral vector; all followed by booster dose of mRNA vaccines ≥2 months after primary series

Modified from: Advisory Committee on Immunization Practices. Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2022. Centers for Disease Control and Prevention. Available at:https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-conditions.html (Accessed on November 1st, 2022) and American Association for the Study of the Liver Disease Expert Consensus Statement: COVID-19 clinical best practice advice for hepatology and liver transplant providers. Available at: https://www.aasld.org/sites/default/files/2022-10/AASLD%20COVID-19%20Guidance%20Document%2010.06.2022F.pdf