May influenza vaccines be given at the same time as other vaccines, including COVID-19 vaccines?

CDC’s clinical guidance for the use of COVID-19 vaccines states that any vaccine may be given on the same day or any day before or after COVID-19 vaccination, at a different anatomic site. According to the CDC’s “General Best Practice Guidelines for Immunization”, simultaneously administering all vaccines for which a person is eligible at the time of a visit increases the probability that a person will be fully vaccinated by the appropriate time.

IIV4 and RIV4 can be administered without regard to the timing of other live or inactivated vaccines. Injectable vaccines should be administered in separate anatomic sites when given on the same day.

LAIV4 may be given on the same day as any other live or inactivated vaccines. However, if two live vaccines are not given on the same day, they should be separated by at least 4 weeks.

There are now several vaccines containing nonaluminum adjuvants recommended for adults (including Shingrix [zoster], Heplisav-B [HepB], Arexvy [RSV] and Fluad [aIIV4, influenza]). Because of the limited data on the safety of simultaneous administration of two or more vaccines containing nonaluminum adjuvants and the availability of nonadjuvanted influenza vaccine options, ACIP advises that selection of a nonadjuvanted influenza vaccine may be considered in situations in which influenza vaccine and another vaccine containing a nonaluminum adjuvant are to be administered at the same visit. However, influenza vaccination should not be delayed if a specific vaccine is not available.