Hepatitis A vaccination is recommended for people with chronic liver disease of any aetiology, if they are not immune to hepatitis A.2,3 This includes:

  • people with chronic liver disease
  • people who have received a liver solid organ transplant
  • people with chronic hepatitis B 
  • people with chronic hepatitis C 

2 doses are required, with a recommended interval between doses of 6 months.

See Table. Recommended doses and schedules for monovalent hepatitis A vaccines

People with chronic liver disease should receive the vaccine as early in the course of the disease as possible. Immune responses to vaccination in these people can vary — for example:

  • people with chronic liver disease of mild to moderate severity mount a good immune response
  • people with end-stage liver disease do not respond as well 
  • liver transplant recipients may not respond at all 4,5

People with chronic hepatitis C or hepatitis B are recommended to receive hepatitis A vaccine because of the high case-fatality rate in this group if they acquire hepatitis A.2

If the person is also at risk of acquiring hepatitis B, they can receive a combination hepatitis A/hepatitis B vaccine. This is usually given in 3 doses. People aged 1 to <16 years can receive a 2-dose schedule using Twinrix 720/20.

See Table. Recommended doses and schedules for combination hepatitis A and hepatitis B vaccines

For more details, see:

Page history

Last updated: 
4 June 2018
Last reviewed: 
4 June 2018