Table 2.
The Centers for Disease Control and Prevention (CDC) Recommendations for Vaccinations for patients With ALD.197,198, 199, 200,201,202
| Vaccine | Frequency | Other Recommendations |
|---|---|---|
| Influenza | Yearly | Best before flu season begins in the community Those who have had a severe allergic reaction to egg (any symptom other than hives) should be vaccinated in a medical setting under supervision |
| Tdap Td (protects against tetanus and diphtheria but not pertussis) |
Tdap or Td booster dose every 10 years, or after 5 years in the case of a severe or dirty wound or burn. | May be given at the same time as other vaccines. |
| Pneumococcal polysaccharide vaccine PPSV23 or PCV13 |
Recommended: PPSV23 for 19 through 64 years with chronic liver disease. Recommended: PPSV23 for >65 years if ≥ 5 years after any PPSV23 at < 65 years Not recommended: PCV13 for 19 through 64 years for chronic liver disease. Recommended: PCV13 for ≥65 years based on shared clinical decision-making. Recommended: PPSV23 ≥ 1 year after PCV13 ∗This does not include solid organ transplant recipients. |
For case-specific situation, please refer to CDC guidelines |
| Hepatitis B | Once for all patients not vaccinated | Hepatitis B vaccine may be given as a stand-alone vaccine or as part of a combination vaccine |
| Hepatitis A | Once for all patients not vaccinated | Patients not previously vaccinated and that have direct contact with someone with hepatitis A should get vaccinated within 2 weeks of exposure. |
| Zoster | Two doses separated by 2–6 months for adults aged 50 years and older | |
| HPV | Once in adults under 26 years old. | HPV vaccination in patients over 27 years old provides less benefit, as more people have already been exposed to HPV. |
| MMR | Once if the patient is born in 1957 or after. | |
| Varicella vaccine | Once if the patient is born in 1980 or after. | |
| SARS- CoV2 | For patients aged 18 years or older: Recommended: BNT162b2 (Pfizer-BioNTech COVID-19 vaccine) Recommended: mRNA-1273 (Moderna COVID-19 vaccine) Recommended: Ad26.COV2.S (Janssen COVID-19 vaccine) Recommended: booster shot of Pfizer-BioNTech's COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series for patients with chronic liver disease. |
Currently there are insufficient data to inform the efficacy and safety of mixing mRNA vaccines for the primary series. |
Abbreviations: ALD: alcohol-associated liver disease; Tdap: Tetanus diphtheria and pertussis; Td: tetanus and diphtheria; PPSV23: pneumococcal polysaccharide vaccine 23; PCV13: pneumococcal conjugate vaccine 13; HPV: human papillomavirus; MMR: measles, mumps, and rubella; SARS-CoV2: severe acute respiratory syndrome - coronavirus 2; mRNA: messenger RNA.