Immunization in Children with Chronic Liver Disease

To support the well being of children with chronic liver disease, protecting them from vaccine preventable diseases is of first priority as the infections cause a significant increase in morbidity and mortality on basis of chronic diseases. The age appropriate immunization schedule is advised to be continued as the patients’ health status permits. All the children with chronic liver disease should be assessed as candidates for organ transplantation. For providing a memory cell pool before immune system depression due to the underlying condition or immunsupressive therapy in these patients, a routine immunization programme is recommended to be completed or practiced as an accelerated schedule in required cases. In immunocompetent patients, routine immunization could be continued up to end stage hepatic insufficiency. If there appears any condition causing immune system depression, proceeding with the routine immunization schedule is recommended with the delay of live vaccines. Along with the patients, evaluating the immunization status of household contacts, health workers involved in the care of patients and the transplantation team is also necessary. Complete protection of chronic liver disease patients from vaccine preventable diseases is as important in treating the disease itself. Thus all health workers involved in the care of patients, particularly primary care physicians should be aware and careful about the subject. Checking the immunization cards at every visit, informing all the parents and older patients about the importance of immunization, following up immunization plan, vaccinating end stage liver disease patients or transplant candidates with accelarated schedules and also following the immunization status of transplant recipients are indispensable factors for the protection and promotion of health.