Can Tdap and Prevnar 20 Be Administered Together?
Yes, Tdap and Prevnar 20 can be safely administered simultaneously at different anatomical sites without concern for increased adverse events or diminished antibody responses. 1
Evidence Supporting Simultaneous Administration
The Advisory Committee on Immunization Practices (ACIP) explicitly states that pneumococcal vaccine may be administered concurrently with other vaccines, including tetanus-containing vaccines, without increasing side effects or decreasing antibody response to either vaccine. 1 This recommendation is based on established data showing that inactivated vaccines like Tdap and pneumococcal conjugate vaccines can be given together safely. 1
Key Administration Guidelines
When administering both vaccines simultaneously:
- Give each vaccine at a different anatomical site (e.g., one in each deltoid muscle) 1
- Use separate syringes for each vaccine 1
- The preferred injection site for adults is the deltoid muscle for both vaccines 1
- Document both vaccines with their respective anatomical sites 1
Clinical Context for Adult Vaccination
For adults with cancer or immunocompromised states, both vaccines are recommended and can be given together:
- Adults aged ≥19 years should receive one dose of PCV20 (Prevnar 20) OR PCV15 followed by PPSV23 1
- Adults should receive one dose of Tdap if never previously received, followed by Td or Tdap boosters every 10 years 1, 2
- Coadministration of two or more recommended non-live vaccines is acceptable per CDC guidelines 1
Important Timing Considerations
There is no required waiting period between vaccines when given on separate days. 1 However, when both are indicated, simultaneous administration is preferred to:
- Improve vaccination coverage rates 1
- Reduce missed opportunities for protection 2
- Minimize patient visits 1
Common Pitfalls to Avoid
Do not delay either vaccine unnecessarily:
- Tdap should be administered regardless of interval since last tetanus-containing vaccine when indicated 1, 2
- The benefits of pertussis protection outweigh potential risks of local reactions from shorter intervals 2
- Immunosuppression (including chemotherapy) is not a contraindication to either vaccine 3
Do not confuse vaccine products:
- Ensure you are using Tdap (not DTaP, which is only for children <7 years) 1, 4
- For adults ≥65 years, Boostrix is preferred over Adacel, though either is acceptable 1, 2
- Prevnar 20 is the 20-valent pneumococcal conjugate vaccine, distinct from PPSV23 1
Special Population Considerations
For adults ≥65 years receiving both vaccines:
- This age group should receive both Tdap (if never received) and PCV20 1, 2
- Simultaneous administration is safe and does not increase adverse events 1
- Local injection site reactions are the most common adverse events and are typically mild to moderate 5
For patients on chemotherapy or immunosuppressed: