For people with a liver condition, it’s important to stay safe from infections. Vaccines are a vital part of that. But some vaccines are not suitable for people with a weakened immune system.
The information on this page is for:
- Adults and children with a liver condition
- Family, friends, carers, and healthcare professionals.
On this page you can find out about vaccines and liver disease. Including which vaccines some people may need to avoid.
If you have questions about vaccines for yourself or a loved one, talk to your liver team. It’s also a good idea to let them know when a vaccine is offered so they can advise you.
On this page:
Is it safe for someone with a liver condition to have vaccines?
People with a liver condition can have a higher risk of becoming very unwell if they pick up an infectious disease.
The risk of dangerous side effects from a UK vaccine is very rare. Even when someone has a liver condition. So, the safest option is usually to have the vaccine and reduce the risk of getting ill.
If someone has a very weak immune system, this could be different. Most people in this group can still have most vaccines. But they may not be able to have “live” vaccines.
Find out more about live vaccines and who can have them below.
Live vaccines FAQs
Is it safe for someone with a liver condition to have vaccines?
People with a liver condition can have a higher risk of becoming very unwell if they pick up an infectious disease.
The risk of dangerous side effects from a UK vaccine is very rare. Even when someone has a liver condition. So, the safest option is usually to have the vaccine and reduce the risk of getting ill.
If someone has a very weak immune system, this could be different. Most people in this group can still have most vaccines. But they may not be able to have “live” vaccines.
Find out more about live vaccines and who can have them below.
What are “live” vaccines?
Infectious diseases are usually caused by a virus or bacteria. Vaccines teach the immune system to look out for a particular infection. There are different ways they can do this. Some use a small part of the virus or bacteria. Some use a whole virus or bacteria that has been killed. “Live” vaccines use a whole virus or bacteria that has been weakened. These are also called “live attenuated” vaccines.
Live vaccines are safe for most people as they are too weak to make someone ill. But there is a small chance that they could cause the disease they are trying to prevent if someone’s immune system is very weak.
Which UK vaccines are live vaccines?
The live attenuated vaccines currently used in the UK are:
MMRV (measles, mumps, rubella and varicella)
- The BCG vaccine for TB (tuberculosis)
- Yellow fever
- Oral typhoid (a vaccine you swallow)
- Some flu vaccines (usually the nose sprays given to children)
- Rotavirus vaccine
- Shingles vaccine
- Varicella vaccine (chicken pox vaccine)
Flu vaccines:
Some types of flu vaccines are live vaccines. The flu vaccines given by injection to adults are not live vaccines. But the nose sprays often given to children are live.
The person giving the flu vaccine should know if it is “live“.
Polio vaccines:
The polio vaccine now used in the UK is not a live vaccine. But the live vaccine is used in some other parts of the world. The live polio vaccine is also known as the oral polio vaccine because it is swallowed not injected.
Some other vaccines that used to be used in the UK were live vaccines. But these have now been replaced by other types of vaccine.
This list was accurate at the time of writing in April 2026
The government publish their vaccine guidelines in the vaccine green book. This is for health care professionals so it is quite complicated. You can find it here.
Who cannot have live vaccines?
Most people with a liver condition can have live vaccines.
But there’s a tiny chance that a live vaccine might cause the disease it aims to prevent. This is more likely to be dangerous if someone’s immune system is not working properly. This is called being immunosuppressed or immunocompromised.
Live vaccines might be a problem for:
- People who have had a liver transplant
- Immunosuppressant medicines after the transplant stop the immune system working properly.
- Anyone having chemotherapy or radiotherapy that suppresses the immune system. Or anyone who has completed this treatment in the last 6 months.
- Anyone having an immunosuppressant biological therapy. Or who has had this treatment in the last 12 months.
- Anyone who is taking any of these medicines or who has taken them in the last 3 months:
- High dose steroids taken for more than 7 days.
- Lower dose steroids taken for more than 14 days.
- Immunosuppressants including azathioprine, methotrexate and 6-mercaptopurine.
This includes steroid medicines that are swallowed, injected, or given in a drip.
Check with the liver team if you are unsure if your, or your child’s doses are in these groups.
It is safe to have live vaccines if the steroid medicines are in an inhaler or cream. For example, asthma inhalers or cream for eczema.
If you’re unsure about a medicine for you or your child, check with your GP or liver team.
Can family, siblings, and close contacts have live vaccines?
Close contacts are people who you spend a lot of time with. They are usually family or other people you live with.
People close to someone with liver disease should get the live vaccines they need.
Children who are a close contact of someone who is immunosuppressed may need to have a different type of flu vaccine. This will be the injected vaccine, which is not live. Check with the immunosuppressed person’s medical team.
The advice used to be that close contacts should not have live vaccines. This was because there is a small risk of someone who has had a live vaccine passing the virus on to the person at risk.
However, this is very rare. For some live vaccines there is no evidence that it has ever happened. Even though millions of people around the world have had the vaccines. The person at risk is more likely to get the disease from someone who has not been vaccinated.
Do people with liver disease need to stay away from someone who has just had a live vaccine?
It’s usually fine for someone with a liver condition to be near a person who has had a live vaccine.
There are some rare exceptions. This applies to people who are very severely immunocompromised. For example, if they have recently had a bone marrow transplant. If you are unsure, talk to the health care team.
For some of the vaccines there are a few things you can do to help make sure the virus isn’t spread. You can find out more about this below. But for all the others, including MMRV and flu vaccines, you can carry on as normal.
Rotavirus
Rotavirus causes a tummy bug. The vaccine is usually given to babies at about 8 and 12 weeks old. Anyone who is close to a baby that got the rotavirus vaccine less than 2 weeks ago should wash their hands very well. Especially after changing a nappy or when making food.
Chicken pox and shingles vaccines (Varicella Zoster)
There are no known cases of someone getting chicken pox or shingles after a close contact has had a vaccine. But it could be possible.
Some people might get a rash after the chicken pox or shingles vaccine. This rash could possibly spread the virus.
If this happens to a close contact, they should stay away from anyone at risk. And avoid face-to-face contact. If the rash is only in a small area, you could ask them to cover it. Once the rash has crusted over it can no longer spread the virus.
Will vaccines work for someone who is immunosuppressed?
Vaccines work by teaching the body to find and get rid of things that shouldn’t be there. This might not work properly if someone is immunosuppressed.
But research has found that most people who are immunosuppressed get some immunity from having a vaccine. It might be a bit less than most people get. And it will vary for different vaccines and for different people. So, you may need to speak to the doctor to get personal advice. But for most people it is usually best to get the vaccine.
Can children with liver disease have all the usual vaccines?
Most children with liver disease should get their normal childhood vaccines. This is important. They might be at a higher risk of becoming very ill if they catch an infectious disease.
Children who have a seriously weakened immune system may not be able to get all the vaccines. Or they might not follow the full normal vaccine schedule.
Your child’s liver team will be able to talk to you about which vaccines your child needs.
Should people with liver disease have the seasonal flu vaccine?
People with long term liver disease have a higher risk of becoming very unwell if they get flu. The type of flu changes over time and it is much more common in the winter. People at risk need to have a flu vaccine every autumn.
This includes anyone aged 6 months or older who:
- has a long term (chronic) liver condition, or
- is immunosuppressed because of a medical condition or medical treatment
There are 2 types of flu vaccine:
- The injected flu vaccine
This is not a live vaccine.
It is usually offered to adults and to children under 2 years old.
- The nose spray vaccine
This is a live vaccine.
It is usually offered to children aged 2-17 years. It is often given at school. Parents are told in advance and have to give permission.
If a child is immunosuppressed, they may need to have the injected vaccines instead of the nose spray. Check with their liver medical team or GP.
Do people with liver disease need extra vaccines?
If you or your child missed any standard childhood vaccines, talk to the liver medical team. They can help you decide if catch-up vaccines are needed.
People with a long term (chronic) liver disease should also get extra vaccines for:
- Hepatitis A
- Hepatitis B
- Flu (influenza)
- Pneumonia (pneumococcal vaccine)
These diseases can be more risky for someone with a liver condition. Some of them can also cause more damage to the liver.
COVID-19 vaccines. Some people will be advised to get seasonal COVID-19 vaccines. You can find out more about COVID-19 vaccines and who should have them here.
Should family, siblings, or close contacts have any extra vaccines?
Close contacts should get all their usual vaccines. This will protect them. It will also protect others by making it harder for a dangerous infection to spread to those at risk.
In some cases, close contacts may need extra vaccines:
Chicken pox vaccine
The chicken pox vaccine was recently added to the childhood vaccine schedule in the UK. It is the V in the MMRV vaccine. But most adults and older children will not have had it.
Close contacts of someone with a weak immune system should have a chicken pox vaccine if:
- they have never had chicken pox or shingles, and
- they have never had a vaccine for chicken pox or shingles.
They should be able to get this vaccine from their GP. It is possible to get it privately at some travel health clinics and pharmacies. But this can be very expensive.
Flu vaccine
Close contacts of someone who is immunosuppressed should have a flu vaccine every year. Even if they would not normally get it. They should be able to get this from their GP. This is usually easier if you both go to the same GP surgery. Flu vaccines can also be paid for from lots of pharmacies in the autumn.
Covid-19 Vaccines
The advice for COVID-19 vaccines still changes regularly. At the time of writing (April 2026), the evidence suggests that COVID-19 vaccines are not necessary for close contacts. They are not currently offered to close contacts on the NHS.
It is now possible to pay for a private COVID-19 vaccine, but this can be expensive.
For more information about the COVID-19 vaccine and links to the latest NHS information see our COVID-19 page here.
Are there other ways to boost immunity?
There are lots of claims that you can boost your immunity using foods or supplements. Unfortunately, there is no evidence that any of them work. The best way to protect yourself and others against infectious diseases is to get vaccinated.
Anyone with a liver condition must also be very careful about taking supplements. Or alternative or complementary medicines.
One of the liver’s jobs is breaking down food and medicine. If the liver is damaged it cannot do this properly. This means there is a higher risk of side effects and even of more damage to the liver. Always talk to a doctor before trying any supplements or alternative medicines.
Find out more about supplements for liver disease.
Learn more about complementary and alternative medicines for liver disease.
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This content was last reviewed: June 2026
Our expert reviewers:
We would like to thank everyone who helped with creating and reviewing this page. Including Dr Neil Rajoriya, consultant transplant hepatologist and Julie Hart, Liver Recipient Transplant Coordinator both at University Hospitals Birmingham, Dr Indra van Mourik, Consultant Paediatric Hepatologist (retired), Safiya Mulla, Paediatric Liver Nurse Specialist Leeds. And all our patient reviewers.
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