Expert Q&A: Coadministration of Flu, COVID-19 Vaccines

As the second year of the COVID-19 pandemic draws to a close, flu season has begun to ramp up. Although the 2020-2021 season had unusually low rates of influenza1—likely due to the infection control measures in place to combat the pandemic—experts are not yet sure what the 2021-2022 season might look like.

Kristen Nichols, PharmD, board-certified pharmacotherapy, pediatric and infectious diseases pharmacist and senior content management consultant for clinical effectiveness at Wolters Kluwer discussed the importance of flu vaccines.

The coadministration of COVID-19 vaccines with other vaccines is acceptable, Nichols explained, adding that there is no recommendation regarding timing of vaccination—therefore they can be administered in patients at the same time without issue.

According to Nichols, the recommendations for previous doses of the COVID-19 vaccine—suggesting that patients wait before receiving any other vaccines—was made from an abundance of caution, because there was not enough data available.

Now, however, there are all kinds of data explaining any adverse effects to the COVID-19 vaccine, and there’s no longer a need to space out the COVID-19 vaccine from any others. However, if a pharmacist does administer two vaccines at the same time, it's recommended to inject them into different sites—or space them 1 inch apart if both must be given in the same arm.

“Patients should be getting both, especially people who have not received any doses yet of the COVID-19 vaccine. Both viruses can certainly cause mild illness, but can also cause more severe illness, resulting in hospitalization. And so, from a general pandemic management perspective, the last thing we need are a bunch of people hospitalized with the flu, right in the middle of our COVID-19 problems,” Nichols explained.

Nichols suggested encouraging patients who are apprehensive of receiving the vaccines at the same time to still get both vaccines—even if that means waiting between them. This is because it is important, she said, to receive both. She additionally recommends patients get the COVID-19 vaccine first, due to the higher risk of serious illness and higher hospitalization rate.

“Even a week is reasonable [to wait],” she said. “Almost all of your adverse reactions to vaccines happen within a week, and so that will give you time to tell—if you had a reaction—whether it was from the COVID-19 vaccine before getting the flu vaccine.”

She explained that this calculation might change a little bit in someone who's fairly young and healthy, but who—for example—has an underlying condition. And in areas with high community flu transmission, providers may choose to give the flu vaccine first.

Coadministering vaccines can benefit pharmacists in other ways, Nichols added. For example, due to the current staffing shortage, an increase in vaccination rate can decrease the illnesses and hospitalizations and lessen the burden on the health care system overall.

“Actively listening to patient’s concerns and reserving judgment can be really important for building that trust and building that relationship,” she said. “There are a lot of people that will let you share information and correct some misperceptions if you take that time to listen and hear what their real concerns are.”

To watch all 3 parts of Nichols’ interview with Drug Topics®, visit the links below.

The Coadministration of COVID-19 and Flu Vaccines, Part 1

https://www.drugtopics.com/view/the-coadministration-of-covid-19-and-flu-vaccines-part-1?seriesVid=1

Part 2: The Coadministration of COVID-19 and Flu Vaccines

https://www.drugtopics.com/view/part-2-the-coadministration-of-covid-19-and-flu-vaccines?seriesVid=1

Part 3: The Coadministration of COVID-19 and Flu Vaccines

https://www.drugtopics.com/view/part-3-the-coadministration-of-covid-19-and-flu-vaccines?seriesVid=1

Reference

1. 2020-2021 flu season summary. CDC. Updated October 25, 2021. Accessed December 2, 2021. https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm