Chronic liver disease patients may benefit from certain vaccines, but their immunization coverage levels have not been widely studied. We examined the serologic and vaccination status of 693 chronic liver disease patients from 37 primary care and specialist centers. Patients in primary care had more often received influenza (47 versus 32%; P < .001)="" and="" pneumococcal="" (39="" versus="" 19%;="">P < .001)="" vaccines.="" among="" patients="" without="" documented="" prior="" exposure,="" those="" seeing="" specialists="" had="" more="" often="" completed="" hepatitis="" a="" (28="" versus="" 5%;="">P < .001)="" and="" hepatitis="" b="" (29="" versus="" 14%;="">P < .001)="" vaccination.="" coverage="" was="" higher="" in="" centers="" with="" a="" policy="" of="" vaccinating="" on-site,="" among="" non-hispanic="" whites,="" and="" among="" patients="" with="" hepatitis="" c="" and="" cirrhosis.="" in="" summary,="" most="" patients="" were="" unprotected="" against="" one="" or="" more="" vaccine="" preventable="" diseases.="" the="" higher="" coverage="" rates="" evident="" in="" centers="" vaccinating="" on-site="" suggests="" a="" breakdown="" may="" occur="" when="" patients="" are="" referred="" to="" alternative="" vaccination="">