Evidence map›Paper›PMID 34975241›Full record

ReviewJournal of clinical and experimental hepatology

Vaccination in Chronic Liver Disease: An Update.

Joseph J Alukal, Haider A Naqvi, Paul J Thuluvath

Open access · greenAbstract readReview
In one paragraph

Review in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.

  1. Pooled it
  2. Traveling with chronic viral hepatitis.Tropical diseases, travel medicine and vaccines · 2026
    Review
  3. Hepatitis B Virus, Pneumococcal, Diphtheria, and Tetanus Vaccination Responses in Compensated Cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  4. Review
  5. Recommended vaccinations for patients with chronic liver diseases.Clinical and experimental hepatology · 2025
    Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Review
  16. Article
  17. Tiza-BMJ open · 2023
    Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

Joseph J AlukalInstitute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore MD, USA.
Haider A NaqviMedstar Health, Baltimore, USA.
Paul J ThuluvathInstitute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore MD, USA.
MedStar Health · USMercy Medical Center · USUniversity of Maryland, Baltimore · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients 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.

Indexed as

ACIP, Advisory Committee on Immunization PracticesACLF, acute on chronic liver failureALD, alcohol-related liver diseasechronic liver diseaseCLD, Chronic liver diseaseCLIF-C, Chronic Liver Failure ConsortiumDAA, direct-acting antiviral drugsHAV, hepatitis A virusHBV, hepatitis B virusHCV, hepatitis C virusimmunizationLT, liver transplantNAFLD, nonalcoholic fatty liver diseaseSARS-CoV-2SOFA, sequential organ failure assessmentvaccines

Identifiers

PMID34975241
PMCPMC8710401
OpenAlexW4200240212

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.