The Benefits of Co-administering COVID-19, Flu 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, a board-certified pharmacotherapy, pediatric, and infectious diseases pharmacist and senior content management consultant for clinical effectiveness at Wolters Kluwer, discussed the importance of influenza vaccines in a multipart interview.

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

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

Now, however, there are data explaining any adverse effects to the COVID-19 vaccine, and there is no longer a need to space out the COVID-19 vaccine from any others. If 2 vaccines need to be administered at the same time, current guidance is to inject into different sites; if vaccines must be given in the same arm, they should be spaced 1 inch apart.

“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 [is many] people hospitalized with the flu right in the middle of our COVID-19 problems,” Nichols explained. According to CDC surveillance data, as of press time on December 20, 2021, 1057 patients had been admitted to hospitals with influenza²—and both COVID-19 and influenza activity is on the rise.

Patients who are apprehensive about receiving the vaccines at the same time should still get both—even if that means waiting between them.

“Even a week is [a] reasonable [time to wait],” she said. “Almost all of your adverse reactions to vaccines happen within a week…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.”

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 patients’ 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.