Yes, Shingrix and flu vaccine can be given on the same day
Shingrix (recombinant zoster vaccine) and injectable influenza vaccine can and should be administered concomitantly on the same day to maximize vaccination coverage. 1
Evidence from FDA Label and Clinical Trials
The FDA label for Shingrix explicitly addresses this question with robust clinical trial data. In a study of 828 adults aged 50 years and older (NCT01954251), one group received Shingrix and quadrivalent influenza vaccine (FLUARIX QUADRIVALENT) simultaneously at Month 0, followed by the second Shingrix dose at Month 2. The comparison group received flu vaccine alone at Month 0, then both Shingrix doses at Months 2 and 4. 1
Key findings:
- No interference with immune response to either vaccine when given together
- Both vaccines maintained their immunogenicity
- Safety profile remained acceptable
General Vaccine Co-Administration Principles
The ACIP guidelines strongly support simultaneous vaccine administration, stating that "simultaneously administering all vaccines for which a person is eligible is critical" because it increases the probability of complete immunization. 2 This principle applies broadly to both live and inactivated vaccines, with extensive clinical experience demonstrating similar seroconversion rates and adverse reaction profiles whether vaccines are given together or separately.
Practical Administration
- Give in separate arms (different injection sites)
- Administer both vaccines during the same visit
- This approach is particularly important for elderly patients who may not return for subsequent visits
- The second Shingrix dose should still be given 2-6 months after the first dose
Safety and Reactogenicity Considerations
Recent post-marketing surveillance data (2018-2024) from VAERS analyzed 791 adverse event reports following co-administration in adults ≥65 years. 3 Only 6.9% were serious adverse events, with most being expected injection site reactions (65%), fever (15.2%), and chills (13.4%). No new safety signals were detected, and the safety profile aligned with giving each vaccine separately.
A comprehensive review of five clinical trials involving 3,974 participants confirmed that co-administration does not significantly alter reactogenicity, immunogenicity, or safety. 4 The most common systemic adverse event was myalgia (38-64% with co-administration vs 30-59% sequential).
Clinical Bottom Line
Do not delay or separate these vaccines. Co-administration improves overall vaccination rates without compromising efficacy or safety of either vaccine. This is especially critical for older adults who benefit most from both vaccines and may have difficulty returning for multiple visits.