Co-Administration of Shingrix and COVID-19 Vaccines
Yes, you can safely receive the Shingrix (zoster) vaccine at the same time as a COVID-19 vaccine. Current guidelines support the simultaneous administration of these vaccines without requiring any specific time interval between them 1, 2.
Evidence Supporting Co-Administration
The Advisory Committee on Immunization Practices (ACIP) explicitly states that COVID-19 vaccines may be administered with other vaccines, including the influenza vaccine and other non-live vaccines like Shingrix 1. This guidance is based on the following principles:
- Inactivated vaccines (like Shingrix and COVID-19 vaccines) are safe to administer simultaneously
- No minimum interval is required between administrations of different inactivated vaccines
- The immune response and safety profile remain acceptable with co-administration
Practical Administration Guidelines
When administering both vaccines simultaneously:
- Administer at different injection sites, preferably in different limbs
- If using the same limb is necessary, separate injection sites by at least 1 inch
- If administering Shingrix with high-dose COVID-19 vaccines that might cause more pronounced injection site reactions, consider using separate limbs 1
Special Considerations for Reactogenicity
Some important points to be aware of:
- Co-administration may potentially increase reactogenicity (temporary side effects like pain, fatigue, headache)
- An interim analysis of co-administration of high-dose influenza vaccine and mRNA COVID-19 booster showed similar overall reactogenicity between the co-administration group and those receiving COVID-19 vaccine alone 1
- No serious adverse events were observed in studies of co-administration
Recommendations for Specific Populations
For patients with rheumatic and musculoskeletal diseases or inflammatory bowel disease:
- Inactivated vaccines like Shingrix and COVID-19 vaccines are considered safe and are not associated with disease exacerbation 1
- The American College of Rheumatology specifically mentions evaluating the impact of co-administration of COVID-19 vaccines with other non-live vaccines, including shingles vaccines, as an important research area 1
- Patients should ideally receive vaccines when not on corticosteroids or at the lowest tolerable dose to optimize immune response 1
Potential Concerns About Herpes Zoster Reactivation
Some case reports have noted herpes zoster reactivation following COVID-19 vaccination 3, 4, 5, 6, 7. However:
- These events are extremely rare (estimated incidence of 0.7/100,000 for zoster reactivation) 7
- Over 90% of reported cases were non-serious 7
- This potential risk does not outweigh the benefits of vaccination
- There is no evidence that co-administration of Shingrix with COVID-19 vaccines increases this risk
Conclusion
The benefits of receiving both vaccines according to recommended schedules outweigh any theoretical risks of co-administration. If you have specific concerns about your individual health status or medications, discuss these with your healthcare provider, but for most people, receiving both vaccines at the same visit is safe and convenient.