Receiving both the seasonal influenza vaccine (flu shot) and the recombinant zoster vaccine (Shingrix) at the same appointment is known as co-administration. This approach offers a practical solution, allowing adults to receive recommended immunizations without requiring multiple trips to a clinic or pharmacy. The flu shot protects against seasonal influenza viruses, while Shingrix prevents the painful rash and nerve complications of shingles, which is caused by the reactivation of the varicella-zoster virus. Since both vaccines are generally recommended for older adults, simultaneous administration improves convenience and helps increase vaccination rates against these two serious health threats.
Official Recommendations for Co-administration
The answer to whether these two vaccines can be given together is definitively yes, according to major public health organizations. The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) advise that the recombinant zoster vaccine (RZV) can be administered concomitantly with other adult vaccines, including the influenza shot, at the same visit. This guidance is founded on the principle that simultaneous administration does not interfere with the immune response generated by either vaccine. Studies have demonstrated that receiving both the flu shot and Shingrix at the same time results in similar levels of protection as when the vaccines are given separately.
The primary rationale for this co-administration policy is to improve compliance and vaccination coverage, especially among older adults who are eligible for both. Clinical trials have not shown an increase in severe adverse events when the two are given together. Both are inactivated or recombinant vaccines, meaning they do not contain live virus, which allows for greater flexibility in scheduling. To ensure safety and minimize localized reactions, healthcare providers typically administer each vaccine into a different arm.
Understanding the Shingrix Schedule
The Shingrix vaccine differs from the annual flu shot because it requires a multi-dose schedule to achieve full protection. For most adults who are 50 years of age or older, the Shingrix series consists of two doses, typically separated by an interval of two to six months. It is important to complete the entire two-dose series to establish the full, long-lasting immunity against shingles and its complications.
The official guidance on co-administration applies to either the first or the second dose of the Shingrix series. Adults who are immunocompromised, including individuals aged 19 and older with certain health conditions, are also recommended to receive two doses of Shingrix. If more than six months pass between the two doses, the series should not be restarted, and the second dose should be given as soon as possible.
Managing Combined Vaccine Side Effects
While co-administration is considered safe and effective, patients should be prepared for potential side effects. The most common side effects from both vaccines are localized reactions, such as pain, redness, and swelling at the injection site. Shingrix, in particular, is associated with a higher likelihood of systemic side effects compared to the influenza vaccine alone.
These systemic reactions can include general symptoms like fatigue, headache, muscle pain, fever, and chills. Receiving both injections at once may increase the overall intensity or duration of these common, temporary symptoms. Studies indicate that systemic reactions like fever and chills occur at rates similar to those seen with Shingrix given by itself.
These reactions usually begin within a day or two of vaccination and resolve on their own within two to three days. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be used to manage discomfort. Applying a cold compress to the injection sites may also help reduce swelling and soreness.