Can Prevnar (pneumococcal conjugate vaccine) and Shingrix (recombinant zoster vaccine) be administered together?

Can Prevnar and Shingrix Be Given Together?

Yes, Prevnar (pneumococcal conjugate vaccine) and Shingrix can be administered concomitantly at the same visit, and the FDA-approved drug label for Shingrix explicitly supports this practice with no evidence of interference in immune response to either vaccine. 1

Direct Evidence from FDA Drug Label

The Shingrix prescribing information includes a dedicated clinical study (NCT03439657) specifically evaluating concomitant administration with Prevnar 13 in adults aged ≥50 years. 1 Key findings include:

• No interference in immune response to antigens in either Shingrix or Prevnar 13 when administered together 1
• Study participants received both vaccines at Month 0, with the second Shingrix dose at Month 2 1
• Immune responses measured by ELISA for Shingrix and MOPA for all pneumococcal serotypes in Prevnar 13 1

Administration Guidelines

Administer both vaccines at separate anatomic sites during the same visit. 2 Specific recommendations include:

• Use different limbs when possible, particularly since both vaccines can cause local injection site reactions 2
• Do not mix vaccines in the same syringe 2
• Administer full recommended doses of each vaccine 3

Important Considerations About Adjuvants

While Shingrix contains the AS01B adjuvant system, the 2024 ACIP guidelines acknowledge limited data on simultaneous administration of multiple non-aluminum adjuvant-containing vaccines. 2 However:

• The specific Prevnar 13 + Shingrix combination has been directly studied and proven safe 1
• ACIP states that vaccination should not be delayed if a specific product is not available 2
• The guideline's caution about adjuvanted vaccines applies more broadly to theoretical concerns, not to this specific combination which has dedicated safety data 2

Clinical Benefits of Concomitant Administration

Simultaneous administration increases the probability that patients will be fully immunized and prevents missed vaccination opportunities. 2, 3 This is particularly critical for:

• Patients unlikely to return for future visits 2, 4
• Ensuring age-appropriate vaccination completion 2
• Reducing the number of clinic visits required 3

Reactogenicity Profile

Both vaccines are associated with injection site reactions, but concomitant administration does not increase severe reactions beyond what is expected from each vaccine individually. 1 The FDA study found:

• Mean age of study population was 63 years 1
• 60% were female 1
• No safety concerns identified with concomitant administration 1

Common Pitfalls to Avoid

• Do not delay either vaccine unnecessarily - the evidence supports same-visit administration 2
• Do not confuse this with live vaccine spacing rules - both Prevnar and Shingrix are inactivated/subunit vaccines requiring no spacing 2
• Do not assume adjuvant concerns override direct study evidence - the specific Prevnar-Shingrix combination has been validated 1
• Ensure proper documentation of both vaccines with anatomic sites recorded 3

Shingrix Dosing Schedule Remains Unchanged

When giving both vaccines together, administer the first Shingrix dose with Prevnar, then complete the Shingrix series with the second dose at 2-6 months. 1, 5