Yes, you can safely receive the flu shot and then get Shingrix one week later.
Based on current CDC/ACIP guidelines and FDA labeling, inactivated influenza vaccines and recombinant zoster vaccine (Shingrix) can be administered simultaneously or sequentially without any required waiting period between them. 1
Key Evidence Supporting Sequential Administration
The 2024-25 ACIP influenza guidelines explicitly state that inactivated influenza vaccines (IIVs) and recombinant influenza vaccines (RIVs) "can be administered simultaneously or sequentially with other inactivated vaccines or live vaccines" 1. There is no minimum interval requirement between these vaccines when given sequentially.
The Shingrix FDA label provides direct clinical trial evidence: a study (NCT01954251) evaluated adults ≥50 years who received either:
- Concurrent administration: flu vaccine + Shingrix dose 1 on day 0, then Shingrix dose 2 at month 2
- Sequential administration: flu vaccine on day 0, then Shingrix doses at months 2 and 4
The study found "no evidence for interference in the immune response to any of the antigens contained in SHINGRIX or the coadministered vaccine" 2. This demonstrates that even same-day administration is safe and effective—making a one-week interval more than adequate.
Important Considerations About Timing
Why One Week Is Fine
- Both vaccines are inactivated/recombinant (not live vaccines), so there are no replication interference concerns
- The one-week interval actually provides a small advantage: it separates potential side effects, making it easier to identify which vaccine caused any reactions
Reactogenicity Management
A practical caveat: Shingrix is notably more reactogenic than influenza vaccine, causing injection site reactions in ~78% and systemic symptoms (myalgia, fatigue, fever) in 45-69% of recipients 2. By spacing them one week apart, you can:
- Attribute side effects to the correct vaccine
- Avoid overlapping peak reactogenicity periods (which occur 1-3 days post-vaccination for both)
- Potentially improve patient tolerance
When Concurrent Administration May Be Preferred
The 2024 ACIP guidelines note that while concurrent administration is acceptable, if giving Shingrix with another adjuvanted vaccine simultaneously, consider using a non-adjuvanted flu vaccine option to minimize overlapping reactogenicity 1. However, this is a consideration for same-day administration only—at one week apart, this concern is irrelevant.
Clinical Pitfalls to Avoid
Do not delay either vaccine unnecessarily. Recent research shows that concurrent administration of flu and zoster vaccines was associated with slightly lower flu vaccine uptake the following year (87.3% vs 91.3%), possibly because patients misattributed Shingrix's side effects to the flu vaccine 3. However, this should not prevent appropriate vaccination—instead, counsel patients explicitly that Shingrix commonly causes arm soreness, fatigue, and sometimes fever for 1-3 days, which is normal and indicates the vaccine is working.
Ensure proper anatomic site separation if vaccines were given same-day (though not your scenario): different limbs are preferred when one vaccine is highly reactogenic 1.
Bottom Line Algorithm
For a healthy adult:
- ✓ Give influenza vaccine today
- ✓ Schedule Shingrix dose 1 for one week later (or any time thereafter)
- ✓ Schedule Shingrix dose 2 for 2-6 months after dose 1
- ✓ Counsel about expected Shingrix side effects before administration
No additional precautions, waiting periods, or monitoring are required beyond standard post-vaccination observation (15 minutes for any vaccine).