What to know
- Coadministration or simultaneous administration of vaccines refers to giving or getting more than one vaccine during a visit.
Coadministration
ACIP Recommendations
Coadministration or simultaneous administration of vaccines refers to giving or getting more than one vaccine during a visit. This is common clinical practice. While there are some exceptions, most vaccines can be given at the same visit.
Why health care providers encourage people to get more than one vaccine at the same time
The idea is to get people up to date on all the vaccines they are due for at one visit in case they are not able to return for additional vaccinations at a later time.
Getting more than one vaccine at the same visit
Vaccines given with a needle at the same visit should be given at separate places on the body (at least one inch apart). Adults and older children can get them in the same arm at least an inch apart, or they can get them in different arms. Young children can get them in the same thigh at least an inch apart, or they can get them in different thighs.
Flu & COVID-19 Vaccines
Flu and COVID-19 vaccines at the same time
People can get a flu vaccine and COVID-19 vaccine at the same visit if they are eligible, and if the timing for each vaccine is right. IIV3s and RIV3 can be administered simultaneously or sequentially with other inactivated vaccines or live vaccines.
Safety of getting a flu and a COVID-19 vaccine at the same time
Studies support the safety of getting a flu vaccine and COVID-19 vaccine at the same visit. For example, one CDC study showed that people who got a flu vaccine and COVID-19 monovalent vaccine at the same time were slightly more likely to have reactions including fatigue, headache, and muscle ache than people who only got a COVID-19 monovalent vaccine, but those reactions were mostly mild and went away quickly.
Reasons to get a flu and a COVID-19 vaccine at the same visit
This might be more convenient than having two separate visits. Getting both vaccines at the same time if you are due for both is an option.
Recommended waiting time between vaccines
There's no recommended waiting time between getting a flu vaccine and a COVID-19 vaccine.
Flu & RSV Vaccines
RSV and flu vaccines at the same time
Getting an RSV vaccine (if you are eligible) at the same visit where you get a flu vaccine is acceptable and is an option that you can talk about with your health care provider.
Safety of getting RSV and flu vaccine at the same time
There are limited data on getting flu and RSV vaccines at the same time since RSV vaccines are new. However, in clinical trials, coadministration of RSV and flu vaccines was safe. Adverse events after coadministration of RSV and flu vaccines were similar to those observed after giving the vaccines separately. Reactions at the injection site might be more common after getting flu and RSV vaccines at the same time than after getting flu vaccine alone. However, vaccination with RSV vaccine and flu vaccine during the same visit is acceptable. Safety monitoring of co-administered RSV vaccine and flu vaccine is ongoing.
What to expect after getting an RSV and flu vaccine at the same time
People who get an RSV vaccine and a flu vaccine at the same visit might be more likely to have injection-site reactions or other common side effects after vaccination. Additional research is occurring to understand this better.
Flu, COVID, and RSV Vaccines
Getting COVID-19, flu, and RSV vaccines at the same time
Flu, COVID-19, and RSV vaccines may be given at the same visit. For eligible patients, this means that if you're only able to make one trip to get your fall and winter vaccines, you can get all of those vaccines at the same visit. Talk with your health care provider about this option. If you prefer to receive each vaccine at a separate visit, there is no minimum waiting period between vaccines. It is important to make sure you are up to date and protected for this season. Talk with a healthcare provider or pharmacist if you have questions about these vaccines.
Getting vaccines that have non-aluminum adjuvants at the same time
An adjuvant is an ingredient in some vaccines that helps promote a better immune response. Aluminum salts, such as aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate have been used safely as adjuvants in vaccines for more than 70 years. Some vaccines have newer non-aluminum adjuvants. There is less experience with giving more than one vaccine with these newer non-aluminum adjuvants at the same time.
One flu vaccine, Fluad, contains a nonaluminum adjuvant. It is licensed and recommended for people aged 65 and older (cross ref to Fluad page). It also can be used for people aged 18 through 64 years who have had a solid organ transplant and are taking medications that suppress the immune system. People who are due for an influenza vaccine and other vaccines that can include adjuvants (such as certain COVID-19 and RSV vaccines) can get a flu vaccine without adjuvant if available. But Fluad can be used if a flu vaccine without adjuvant is not available. Your healthcare provider can help choose the best options for flu, COVID-19, and RSV vaccines based on year age and medical conditions.