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dc.contributor.authorAlukal, Joseph J
dc.contributor.authorNaqvi, Haider A
dc.contributor.authorThuluvath, Paul J
dc.date.accessioned2022-01-19T16:38:25Z
dc.date.available2022-01-19T16:38:25Z
dc.date.issued2021-12-08
dc.identifier.urihttp://hdl.handle.net/10713/17622
dc.description.abstractPatients with chronic liver disease (CLD) with or without cirrhosis remain at risk of developing hepatic decompensation when infected with viral or bacterial pathogens. The Advisory Committee on Immunization Practices (ACIP) currently recommends vaccination in CLD against hepatitis A virus (HAV), hepatitis B virus (HBV), influenza, pneumococcus, herpes zoster, tetanus, diphtheria, pertussis, and SARS-CoV-2. Inactivated vaccines are preferred over live attenuated ones, especially in transplant recipients where live vaccines are contraindicated. As the severity of the liver disease progresses, vaccine efficacy declines, and therefore, vaccines should be ideally administered early in the disease course for optimal immune response. Despite the strong recommendations, overall vaccination coverage in CLD remains poor; however, it is encouraging to note that in recent years coverage against influenza and pneumococcus has shown some improvement. Inadequate access to healthcare, lack of information on vaccine safety, poor financial reimbursement for healthcare providers, and vaccine misinformation are often responsible for low immunization rates. This review summarizes the impact of vaccine-preventable illness in those with CLD, updated vaccine guidelines, seroconversion rates in the vaccinated, and barriers faced by healthcare professionals in immunizing those with liver disease.en_US
dc.description.urihttps://doi.org/10.1016/j.jceh.2021.12.003en_US
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc8710401/en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofJournal of Clinical and Experimental Hepatologyen_US
dc.rights© 2021 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.en_US
dc.subjectACIP, Advisory Committee on Immunization Practicesen_US
dc.subjectACLF, acute on chronic liver failureen_US
dc.subjectALD, alcohol-related liver diseaseen_US
dc.subjectCLD, Chronic liver diseaseen_US
dc.subjectCLIF-C, Chronic Liver Failure Consortiumen_US
dc.subjectDAA, direct-acting antiviral drugsen_US
dc.subjectHAV, hepatitis A virusen_US
dc.subjectHBV, hepatitis B virusen_US
dc.subjectHCV, hepatitis C virusen_US
dc.subjectLT, liver transplanten_US
dc.subjectNAFLD, nonalcoholic fatty liver diseaseen_US
dc.subjectSARS-CoV-2en_US
dc.subjectSOFA, sequential organ failure assessmenten_US
dc.subjectchronic liver diseaseen_US
dc.subjectimmunizationen_US
dc.subjectvaccinesen_US
dc.titleVaccination in Chronic Liver Disease: An Update.en_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.jceh.2021.12.003
dc.identifier.pmid34975241
dc.source.journaltitleJournal of clinical and experimental hepatology
dc.source.countryIndia


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