Table 1.

Key recommendations on COVID-19 vaccination

Patients with chronic liver disease

Liver transplant recipients

Recommended for all patients; if the vaccine supply is limited, patients with higher Model for End-Stage Liver Disease should be prioritized Antiviral therapies in patients with CLD, locoregional, or systemic therapy in patients with hepatocellular carcinoma, and treatment for primary biliary cholangitis or autoimmune hepatitis need NOT be interrupted while receiving COVID-19 vaccination For patients with recent infections or fever, ruling out active infection prior to receiving a COVID-19 vaccine is recommended Whenever possible, candidates for liver transplant should receive a COVID-19 vaccine BEFORE transplantation Household members and health care workers are advised to take a COVID-19 vaccine, along with maintaining non-pharmacological interventions (NPIs), such as universal masking, hand hygiene, and physical distancing

Recommended for all liver transplant recipients In patients with a severe COVID-19 risk, the COVID-19 vaccine can be given 6 weeks after transplant (mRNA vaccine preferable); otherwise, 3 or more months post-transplant is suggested Reducing immunosuppression may cause acute cellular rejection (ACR), and hence, NOT recommended Patients need to be evaluated for ACR or viral hepatitis if they have a persistent elevation of liver test parameters post COVID-19 vaccination Deceased donor liver transplantation should NOT be delayed in recipients of COVID-19 vaccines COVID-19 vaccination of close contacts (household members and health care professionals) is recommended along with strict adherence to preventive measures