But wait: Can you get your COVID booster (or regular COVID vaccine) and flu shot at the same time, or do you have to space those shots out? Here’s everything you need to know about how to time your flu and COVID vaccines.
Yes, you can get these shots at the same time
When the COVID-19 vaccines were first released, the timing was a concern. Experts recommended not getting vaccinated for anything else for a certain amount of time before or after getting vaccinated for COVID. But you no longer need to figure out how to space out getting a seasonal flu shot and a COVID shot, regardless of which dose of the COVID series you’re getting. “It used to be the case that we would advise people to separate the COVID shot for two weeks before or after any other vaccine,” saysDr. Darvin Scott Smith, MD, chief of infectious disease and geographic medicine for Kaiser Permanente in Redwood City, in California. “That’s no longer the directive.” Over time, as millions of people received doses, experts gained more knowledge about the COVID-19 vaccine. They were able to look at whether the timing of vaccine administration was an issue, explains David Souleles, MPH,director of the COVID-19 Response Team at the University of California, Irvine. “There are no timing concerns now,” he says. Flu season typically starts in the fall, with cases of flu beginning to ramp up in October. Peak flu season usually occurs between December and February, although flu activity can last through May, according to the Centers for Disease Control and Prevention (CDC).
Will side effects be worse if you get both vaccines at the same time?
As flu season approaches, many people are thinking about vaccine timing. They’re wondering if they should get their flu shot first and then get a COVID booster, or if they should get a COVID booster first and then get a flu shot. “They should actually do both,” says Dr. Jonathan H. Watanabe, PharmD, PhD, associate dean of assessment and quality and professor of clinical pharmacy at the University of California, Irvine. “There’s not any contraindication, at least from the CDC, about whether they could take both, and that’s probably what I would recommend. From reviewing prior studies of non-COVID vaccines, we can say that likelihood of having a side effect is generally the same when vaccines are given at the same time as when they are injected on separate visits.” In fact, you could even get them at the same time, if they’re offered at the same place. (Dr. Watanabe suggests getting the shots in locations at least one inch apart if you go that route.) It’s hard to know if you’ll feel lousy afterward—as many people did after their first COVID vaccine doses.But if that’s your concern, you could space them out a little. “It’s more personal preference,” says Dr. Watanabe, who also serves as an appointed member of the National Academies of Sciences, Engineering, and Medicine Forum on Drug Discovery, Development, and Translation. “It’s not CDC guidance.” But it is safe, says Dr. Smith.“And for convenience, that might be the strategy, to go ahead and get them together on your visits,” he says.
Who’s eligible for boosters right now?
Of course, this whole issue—or whether or not it’s an issue at all—is dependent on whether you’re actually eligible for a COVID booster. And right now, that’s still a relatively small group of people. In August, the CDC announced that it was recommending that people who are moderate to severely immunocompromised receive an additional dose of one of the mRNA COVID vaccines. This includes people who have:
Undergone an organ transplant and taken immunosuppressive medicationsUndergone a stem cell transplant in the last two yearsBeen receiving treatment for cancerHave a moderate or severe primary immunodeficiencyHave advanced or untreated HIVReceiving treatment immunosuppressive medication like high-dose corticosteroids
The U.S. Food and Drug Administration (FDA) also approved it, amending the emergency use authorization for both the Pfizer-BioNTech vaccine and the Moderna vaccine to include a booster for immunocompromised people. But technically, it’s not a COVID booster shot for these people. It’s a third dose of the same mRNA vaccine. This additional dose is intended to help them build up adequate protection against COVID, since many immunocompromised people don’t mount a robust response with the first two doses. The CDC recommends that they get this third dose at least 28 days after completing the original two-dose series. The FDA and the CDC also recently gave the thumbs up for people over 65 to get a third dose of the Pfizer-BioNTech COVID vaccine. People between the ages of 18 and 64 who are at high risk for severe COVID are also eligible, as are people with occupations that put them at high risk. According to a statement released by the CDC on September 24, people in institutional settings are also eligible for a booster dose of the Pfizer-BioNTech COVID-19 vaccine. People in long-term care settings should get the third dose at least six months after their primary two-dose series. The six-month recommendation also applies to the other populations. If you don’t fit into one of the approved categories, you may not be eligible for a COVID booster for a while. But for how long?No one knows for sure at this point. It’s an issue that’s been controversial for some time. Although the White House COVID-19 Response Team advocated for a Sept. 20 start date for making COVID boosters available to the general public, the CDC and FDA haven’t indicated that they’ll approve that idea anytime soon. So, if you’re not sure you’ll be able to get a third dose of the COVID vaccine anytime soon, you can still get a flu shot. “I think people should feel comfortable to get the flu vaccine as soon as they can this season and not think they have to wait until they get a COVID vaccine," says Souleles.
Should I wait to get other vaccines if I’m getting a COVID shot?
According to the CDC, you don’t need to worry about the timing with a COVID-19 vaccine and any other vaccines, either. That includes live attenuated vaccines like the measles-mumps-rubella (MMR) vaccine. There’s no reason not to get them simultaneously if you need to get them. But as the CDC notes, “It is unknown whether reactogenicity of COVID-19 vaccine is increased with co-administration, including with other vaccines known to be more reactogenic, such as adjuvanted vaccines or live vaccines.” And regardless of whether or not you are eligible for a COVID booster or third COVID shot, you should consider getting a flu shot sooner rather than later. While we never know exactly how bad flu season will be, “there are some indicators such as early spikes in the respiratory syncytial virus in a few states that it will be rougher this year,” says Dr. Watanabe. “This may be a bad year for flu as well,” agrees Dr. Carlos Malvestutto, MD, MPH, an infectious disease physician with The Ohio State University Wexner Medical Center, who also urges people to get a flu vaccine as soon as they can. “Like it or not, things are reopening and mask-wearing has gone down, and kids are back in school.” Eventually, you might even have the option to get a combination COVID booster/flu shot. Novavax recently announced that it was beginning a clinical trial in Australia for a combined shot, and Moderna is also embarking upon a combination shot. Next up: We Keep Hearing About a COVID Booster—but Who Actually Gets It, and Are You Eligible?
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