Simultaneous COVID-19, Influenza Vaccines Comparable with Sequential Immunization
Researchers compared simultaneous and sequential administration of the mRNA COVID-19 and inactivated influenza vaccines.
Study participants who received the mRNA COVID-19 and inactivated influenza vaccines (IIV4) simultaneously showed statistically similar results when compared with sequential administration of each vaccine. The study findings present another option for the administration of COVID-19 and influenza vaccines that could be even more convenient than others, especially during times of increased respiratory illness, according to data published in JAMA Network Open.1
“Since both influenza and SARS-CoV-2 viruses tend to cause winter peaks of disease, prevention efforts target administering both vaccines during the late summer and early fall. To facilitate the convenient delivery of these vaccines to the public, the [CDC] Advisory Committee on Immunization Practices (ACIP) guidance allows for their simultaneous administration at different anatomic sites,” wrote authors of the study.
READ MORE: Simplifying Vaccine Access Translates to Better Uptake
Coadministration, or simultaneous administration, of vaccines refers to giving or getting more than 1 vaccine during a visit, according to the CDC's definition. | image credit: Alina / stock.adobe.com
With the COVID-19 pandemic’s impact still lingering across public health sectors, researchers are working to better understand SARS-CoV-2 viruses and how they interact with influenza and other respiratory diseases. There is currently a limited amount of research regarding simultaneous administration of the COVID-19 vaccine and IIV4. Researchers attempted to determine if simultaneous administration was superior to sequential administration.
The main goal of the study was to compare the 2 routes of administration by finding patients’ reactogenicity, safety, and changes in health-related quality of life (HRQOL) after receiving each vaccine. The study design was a randomized, placebo-controlled clinical trial that was conducted between October 8, 2021, and June 14, 2023.1
“Coadministration, or simultaneous administration, of vaccines refers to giving or getting more than 1 vaccine during a visit,” wrote the CDC.2 “The idea is to get people up to date on all the vaccines they are due for at 1 visit in case they are not able to return for additional vaccinations at a later time.”
In the researchers’ study, at visit 1, patients were given the intramuscular administration of either IIV4 (simultaneous group) or a placebo (sequential group) simultaneously with a COVID-19 vaccine in separate arms. Patients who received placebo at visit 1 were then given IIV4 at visit 2. While all study participants were given the illusion that they’d be receiving both vaccines at visit 1, about half of the population would have to come back for the non-placebo influenza vaccine at visit 2.1
The study results consisted of a randomized group of 335 individuals (mean [SD] age, 33.4 [15.1] years; 63% women). Although not directly a 1:1 split, the simultaneous administration group included 169 participants and the sequential administration group included 166. A majority (86.3%) of study participants were in between 18 and 64 years old.
“The primary composite reactogenicity outcome was the proportion of participants with fever, chills, myalgia, and/or arthralgia of moderate or greater severity within 7 days after vaccination visits 1 and/or 2, using a 10% noninferiority margin,” they continued.1
Researchers determined that individuals’ reactogenicity in the simultaneous group (25.6%) was statistically noninferior to the sequential group (31.3%). However, they were unable to deem simultaneous administration as superior to its counterpart.
With issues of drug shortages and pharmacy deserts plaguing the pharmacy industry, access to care has become a challenge as of late. As respiratory virus season wages on this winter—aside from drugs and pharmacy services—vaccines are crucial infrastructure to US health care. Systemic challenges are nothing new to pharmacists and their peers, but when they find opportunities to highlight their expertise, these providers tend to take advantage.
Immunization has the potential to be one of the most notable services a pharmacist can provide.
“Pharmacist involvement as immunizer, advocator, or both roles has favorable effects on immunization uptake, especially strong evidence for influenza vaccine,” wrote authors of a study published in the Journal of the American Pharmacists Association.3 “In addition, interventions with pharmacist involvement also had an impact on other related outcomes (patient attitude toward vaccines, pharmacist confidence in vaccine recommendation and administration, vaccine compliance and appropriateness, and patient satisfaction), which indirectly improves the vaccine coverage.”
While there is more evidence supporting both coadministration and pharmacists’ ability as immunizers, vaccine uptake continues to be an issue for health care experts and their patients. Researchers have presented the evidence that makes it easier for patients to be better protected from some of the most notable diseases in history; it’s now on providers to seek out opportunities to practice at the top of their license and on patients to seek out opportunities to keep themselves and their loved ones healthy against diseases like influenza and SARS-CoV-2.
“This trial lends support to the option of simultaneous administration of these vaccines, which is a strategy to achieve high levels of vaccination coverage during anticipated periods of increased influenza and SARS-CoV-2 virus transmission,” concluded authors of the study.1
READ MORE: Immunization Resource Center
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