NASH & Chronic Liver Disease: An Essential Vaccine Guide for Patients
Somehow, vaccines have become a topic that divides people. However, if you look past the noise, you’ll find plenty of research that shows the benefits of vaccines. Beyond antibiotics, little else has changed in health care as much as vaccines have. Over the past 100 years, life expectancy has increased by 20-30 years. We also have fewer disabilities caused by viral infections, such as hearing loss, vision loss, or paralysis.1
As a healthcare provider, I see that people often think vaccines are only for the very young and the very old. However, people with serious health problems also need vaccines. They reduce the risk of severe illness from viruses such as the flu, pneumonia, and shingles. This includes those living with chronic liver disease, like nonalcoholic steatohepatitis (NASH).2
Your liver and your immune system
The immune system is how your body keeps you healthy. It helps kill germs like viruses and bacteria. It also removes substances your body doesn’t recognize, including your own cells that are not growing properly.
The liver stores vital immune cells and proteins. Nearly 30% of your body’s blood passes through your liver every minute. The liver also helps with digestion and gut function.3
Because your liver works closely with both your immune and digestive systems, it is great at finding and destroying germs. It can do this even if it hasn't seen that specific germ before. Below are common vaccines for individuals with NASH and other liver conditions.3
Vaccines for people with NASH: Protecting your liver
It is important to talk to your doctor about the essential vaccines you may need. For most people, receiving these shots can reduce the risk of severe illness. As with any health decision, you and your doctor should discuss the risks and benefits for you.
Influenza (flu) vaccine
The flu is a lung and throat infection. Studies find that people with chronic liver disease have a higher risk of getting very sick or dying from the flu. Even with fast treatment, the rate of death and other problems—like liver swelling—was higher. The yearly flu shot is recommended for people with chronic liver disease.2
Pneumococcal vaccine
These infections are most often caused by a germ called S. pneumoniae. This germ can cause infections in your blood, lungs, brain, and nervous system. Research shows that people with chronic liver disease have nearly double the risk of getting serious infections from this germ. In fact, it is the most common cause of pneumonia in those with liver disease.2
The PPSV23 vaccine is recommended for individuals under 65 with chronic liver disease. If you are older than 65, you need another shot of PPSV23. You might also need the PCV13 vaccine.2
COVID-19 vaccine
Studies show people with chronic liver disease have a higher risk of problems and death from COVID-19. This is especially true for those with cirrhosis. An annual COVID-19 vaccine is recommended for individuals with chronic liver disease.2
Hepatitis A and B vaccines
If you already have a liver condition like NASH, getting another liver infection like hepatitis can be hard on your body. In some cases, it can increase the risk for cirrhosis or liver cancer. Sometimes, these vaccines may not work quite as well for people with liver disease. Even so, hepatitis A and B vaccines are still recommended. They are available as a single shot or separately. These vaccines usually need 2 to 3 doses.2
Herpes zoster (shingles) vaccine
Right now, chronic liver disease does not seem to increase your risk of getting shingles. However, aging is one of the major risk factors. For that reason, people over age 50 with chronic liver disease are told to get the two-dose Shingrix vaccine.2
Tdap (tetanus, diphtheria, pertussis) vaccine
This vaccine reduces the risk of infection with tetanus, diphtheria, and whooping cough. People often think of these as childhood illnesses, but they can happen at any age. Recommendations for people with liver disease are the same as for everyone else. You should get a booster every 10 years.2
Work with your care team
Again, its important to speak with your own healthcare provider about the risks and benefits of vaccines.
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