Patients with chronic liver diseases and specially with cirrhosis have an impaired immune system and are vulnerable to viral (co-) infections. Vaccination against hepatitis A and B virus (HAV, HBV) is recommended for all patients with chronic liver diseases. However, the efficacy of vaccinations in patients with end-stage liver diseases and transplant recipients is disappointing. As soon as a chronic liver disease is diagnosed patients should be immunized with the common vaccines (flu and pneumoccocci). Due to reduced seroconversion rates, antibody levels should be tested after a booster vaccination.