Flu Vaccine and TB Test Placement: Concurrent Administration
Yes, a patient can and should receive the flu vaccine at the same time as tuberculosis (TB) test placement without any delay or separation required. 1
Key Recommendation
Inactivated influenza vaccines (IIV) and recombinant influenza vaccines (RIV4) may be administered concomitantly or sequentially with other inactivated vaccines or live vaccines, including at the time of TB skin test placement. 1 Injectable vaccines given concomitantly should be administered at separate anatomical sites. 1
TB Skin Test Timing Considerations
The critical timing issue relates to when the TB test is read, not when it is placed:
- Measles-containing vaccines (like MMR) can temporarily suppress tuberculin reactivity, but this does not apply to influenza vaccines. 1
- Influenza vaccine does not interfere with TB skin test reactivity and can be given on the same day as TB test placement. 1
- The TB skin test should be read at the standard 48-72 hours after placement, regardless of flu vaccine administration. 1
Evidence Supporting Concurrent Administration
- Inactivated vaccines do not interfere with immune responses to other inactivated vaccines or to live vaccines. 1, 2 The TB skin test (tuberculin) is not a vaccine but a diagnostic test, and influenza vaccination does not affect its interpretation. 1
- Multiple studies demonstrate that simultaneous administration of inactivated vaccines produces similar seroconversion rates and adverse reaction profiles compared to separate administration. 1
Clinical Implementation
Administer both procedures during the same visit by:
- Placing the TB skin test intradermally on the forearm 1
- Administering the flu vaccine intramuscularly in the deltoid of either arm 1
- Using separate anatomical sites for any injectable vaccines given the same day 1
Common Pitfalls to Avoid
Do not delay either the flu vaccine or TB test placement to give them separately—this creates unnecessary missed opportunities and leaves patients vulnerable during delay periods. 2 The only vaccine that requires consideration of TB test timing is live measles-containing vaccine (MMR), which should either be given the same day as TB testing or the TB test should be postponed for ≥4 weeks after MMR vaccination. 1 This restriction does not apply to inactivated influenza vaccines. 1