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Vaccinations you should have with cirrhosis | CION Cancer Clinics
Most adults with cirrhosis are advised to be protected against hepatitis A, hepatitis B, flu and pneumonia, and to keep tetanus and COVID-19 protection current. Infections hit a scarred liver much harder, and vaccines lower that risk without harming the liver. This page explains each vaccine, who already has protection, and how vaccines fit around cancer treatment. At CION Cancer Clinics, our specialists help you understand your own risk and plan regular liver checks that fit it.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Which vaccines should I have if I have cirrhosis?
- What does each vaccine protect against, and why does it matter?
- How do I get vaccinated while I am having cancer treatment?
- What do the words on my blood test mean?
- What do families believe about vaccines and liver disease?
- What this page cannot tell you
- Common questions about vaccines and cirrhosis
The short answer
Which vaccines should I have if I have cirrhosis?
Most adults with cirrhosis are advised to be protected against hepatitis A, hepatitis B, flu and pneumonia, and to keep tetanus and COVID-19 protection up to date. Your doctor will check which ones you already have and which you still need, and fit them around any cancer treatment.
Why infections matter so much more now
A scarred liver is also a weaker part of the immune system. Infections that a healthy person shakes off can push a cirrhotic liver into failure, bring on confusion or start bleeding. A fresh hepatitis infection on top of cirrhosis can be very dangerous. Vaccines are one of the simplest ways to lower that risk, and they do not harm the liver.
Who this page is for
This page is for adults with cirrhosis, including those who also have primary liver cancer (hepatocellular carcinoma, or HCC). If you have had a liver transplant, your transplant centre has its own vaccine plan and you should follow that instead. Children follow the national childhood schedule. More on why infections escalate is on the page about infections in cirrhosis.
A vaccine cannot treat cirrhosis or cancer. It protects the liver you have left.The usual list
What does each vaccine protect against, and why does it matter?
Not every person needs every vaccine. Some of you will already be protected from an old infection or earlier vaccination.
Hepatitis A
Spread through contaminated food and water. Many adults in India had it in childhood and are already immune. A blood test can show this. If you are not immune, the vaccine is usually advised, because hepatitis A in a cirrhotic liver can be severe.
Hepatitis B
Advised if your blood test shows you have never had hepatitis B and are not protected. If you already carry hepatitis B, the vaccine is not for you. Your household should be checked and vaccinated instead.
Vaccines work less strongly in cirrhosis, so a follow-up blood test may be done to confirm protection.Flu and pneumonia
Flu can trigger a sudden decline in liver function. The flu vaccine is usually given every year. The pneumococcal vaccine protects against a common cause of pneumonia and blood infection.
Often also advised
- COVID-19 vaccine and boosters as advised
- Tetanus, kept up to date
- Shingles, for some older adults
Vaccines that need more care
Live vaccines, made from a weakened germ, are usually avoided during chemotherapy and in people whose immunity is low. Your doctor will tell you which ones these are.
Not sure whether this applies to you?
Ask an oncologistMaking it happen
How do I get vaccinated while I am having cancer treatment?
Ask at your next visit
Ask your oncologist or hepatologist which vaccines you still need. Bring any vaccination card or old reports you have, even from years ago.
Check what you already have
Blood tests can show whether you are already protected against hepatitis A and B. This avoids vaccines you do not need.
Time it around treatment
Vaccines are often best given before treatment starts, or at a point in the cycle when your blood counts are steady. Your oncologist will pick the moment, especially during chemotherapy or immunotherapy.
Get the vaccine where your doctor advises
Most vaccines are given at a clinic, a hospital or a government centre. Prices vary by brand and by place. Ask before you go.
Write it down
Keep the name of each vaccine and the date in one place, and show it at every visit. Ask whether a follow-up blood test is needed. The page on checking whether the vaccine worked explains that test.
On your report
What do the words on my blood test mean?
- HBsAg
- A sign that hepatitis B is present in the body now. If it is positive, the hepatitis B vaccine is not for you.
- Anti-HBs
- Protection against hepatitis B, from vaccination or a past infection that cleared. Used to check whether a vaccine has worked.
- Anti-HAV IgG
- Protection against hepatitis A, usually from a childhood infection. If it is positive, you do not need that vaccine.
- Live vaccine
- A vaccine made from a weakened germ. Usually avoided when immunity is low, such as during chemotherapy.
- Booster
- An extra dose given later to keep protection strong. Your doctor will say whether you need one.
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Commonly believed
What do families believe about vaccines and liver disease?
"Vaccines are for children, not for a sick adult."
People with cirrhosis are among the adults who benefit most. The vaccines on this page are given to adults precisely because an ordinary infection can hit a damaged liver hard.
"A vaccine will put more strain on my liver."
The common vaccines are not processed in a way that harms the liver. The infection they prevent is the real strain. If you have a worry about a specific vaccine, ask your doctor directly.
"I already have hepatitis B, so my family is safe from it."
The opposite. Living with someone who carries hepatitis B means your family should be tested and vaccinated if they are not protected. Read about vaccinating the household.
"I cannot have any vaccine during cancer treatment."
Many vaccines can be given during treatment. Some are timed carefully, and live vaccines are usually avoided. Your oncologist will decide which and when.
Did you know
There is still no vaccine against hepatitis C. Protection comes from avoiding shared needles and unsafe equipment, and from testing. Hepatitis C is curable with modern tablets, which a hepatologist arranges.
Being straight with you
What this page cannot tell you
It cannot tell you which vaccines you personally need, or the right timing for you. That depends on your blood tests, what you were given in the past, how advanced the cirrhosis is and what cancer treatment you are having. Schedules also change as guidance is updated, so ask your doctor for the current advice.
Who this does not apply to
It does not apply to people who have had a liver transplant, who follow their transplant centre's plan. It does not replace the childhood schedule for children. It is also not the full story for people whose immunity is very low from treatment, who may need a specialist to plan each vaccine. If you have had a serious reaction to a vaccine before, tell the doctor before any new one.
What CION can help with
CION's oncologists can review your vaccine needs alongside cancer treatment and tell you when in the plan to have them. Hepatitis care, including hepatitis B treatment, is coordinated through partner hepatologists.
Bring your vaccination card and old hepatitis reports to your next appointment.Questions we are asked
Common questions about vaccines and cirrhosis
Is the flu vaccine safe with cirrhosis?
Yes, for most people. The flu vaccine given as an injection is not live and does not harm the liver. It is usually advised every year, because flu changes and protection fades. If you are on chemotherapy, your oncologist will tell you the best time to have it.
Do I need the hepatitis A vaccine if I grew up in India?
Possibly not. Many adults who grew up in India had hepatitis A as children and are already immune. A simple blood test can show whether you are protected. If you are not, the vaccine is usually advised, because hepatitis A can be severe in a cirrhotic liver.
Why did my doctor test my blood after the hepatitis B vaccine?
Vaccines often work less strongly when the liver is scarred. The test checks whether your body has made enough protection. If it has not, your doctor may suggest further doses or a different approach. This is common and does not mean anything went wrong.
Can I have vaccines during immunotherapy?
Usually the non-live vaccines can be given, and some doctors prefer to give them before treatment starts. Live vaccines need more caution. Ask your oncologist before any vaccine during treatment. More on the medicines themselves is on the immunotherapy pages.
Do my family members need vaccines too?
If you carry hepatitis B, yes: household members should be tested and vaccinated if they are not protected. Their flu vaccine also helps protect you. This is about keeping everyone safe, not about blame. Hepatitis B spreads within families through blood, not through sharing food.
Is there a vaccine that prevents liver cancer?
The hepatitis B vaccine lowers the risk of liver cancer caused by hepatitis B in people who have never had the infection. It does not reverse cirrhosis or treat a cancer already present. If you have cirrhosis, regular surveillance scans still matter.
Are adult vaccines expensive?
Costs vary by vaccine, brand and where it is given. Some vaccines are available at government centres. Ask your doctor which ones are a priority for you if cost is a concern, and ask the clinic for the price before you go.
Who should I ask about my vaccines?
Your oncologist, hepatologist or the physician who manages your liver. Bring your vaccination card and recent blood reports. If you are not sure where to start, call the CION helpline and someone will guide you to the right clinic.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- NHS — Cirrhosis
- Liver UK (formerly British Liver Trust) — Cirrhosis
- NHS — Hepatitis B
- MedlinePlus — Hepatitis
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Not sure which vaccines you still need?
Bring your vaccination card and your hepatitis reports, and a CION oncologist will help you plan vaccines around your treatment. One helpline serves every CION centre.