Can Tdap and RSV Vaccines Be Given on the Same Day?
Yes, Tdap and RSV vaccines can and should be administered on the same day when both are indicated. Both are inactivated vaccines that do not interfere with each other's immune responses and can be safely coadministered. 1
Evidence Supporting Coadministration
The fundamental principle guiding this recommendation is that inactivated vaccines may be administered concomitantly with, or at any time before or after, other inactivated vaccines. 2 This applies directly to both Tdap and RSV vaccines, as both are inactivated formulations.
- Multiple guidelines explicitly confirm that inactivated vaccines do not interfere with immune responses to other inactivated vaccines 2, 1
- Coadministration of two or more recommended nonlive vaccines is acceptable, and when given on separate days, there is no recommended waiting period 1
- The 2024 guidelines specifically note that Tdap can be given concomitantly with other inactivated vaccines 2
Proper Administration Technique
When administering both vaccines on the same day, follow these specific guidelines:
- Use a separate syringe for each vaccine and administer at different anatomic sites 1, 3
- Tdap should be given as 0.5 mL intramuscularly, preferably into the deltoid muscle 3
- Some experts recommend administering no more than two injections per muscle, separated by at least one inch 3
Safety Profile
The safety data support same-day administration:
- A phase 2b study demonstrated that RSV prefusion F vaccine was safe and well tolerated when administered with Tdap in women aged 18-49 years 4
- Local reactions and systemic events were generally similar whether vaccines were given together or separately 4
- Observe patients for 15-20 minutes following vaccination, as syncope can occur after vaccination and may be more common among adolescents and young adults 1, 3
Immunogenicity Considerations
While coadministration is safe, there are nuances regarding immune responses:
- Anti-RSV immune responses were noninferior when RSV vaccine was given with Tdap compared to alone 4
- Immune responses to tetanus and diphtheria components of Tdap were noninferior when given with RSV vaccine 4
- Pertussis component responses showed marginal differences that slightly exceeded pre-specified noninferiority limits, though antibody concentrations remained above protective thresholds 4, 5
The clinical significance of these marginal differences in pertussis antibody responses is minimal, as concentrations still exceeded those associated with vaccine efficacy in infants. 5
Special Populations
Coadministration is appropriate even in special circumstances:
- Patients with stable neurologic disorders or immunosuppression can receive both vaccines, though immune responses may be suboptimal in immunocompromised individuals 1
- Minor illnesses without fever are not contraindications for vaccination 1, 3
- Breastfeeding is not a contraindication 2
Common Pitfalls to Avoid
- Do not delay vaccination waiting for separate visits—simultaneous administration increases the likelihood that patients receive vaccines on schedule 3
- Be aware that some vaccine syringes contain latex in the tip and rubber plunger, which matters for patients with anaphylactic latex allergies 2, 3
- Ensure proper documentation of both vaccines to prevent unnecessary revaccination 3