Can COVID-19 and Shingles Vaccines Be Given Concurrently?
Yes, COVID-19 and shingles vaccines can and should be administered at the same visit, given at separate anatomic sites. 1, 2
Evidence-Based Rationale
Inactivated vaccines, including both COVID-19 vaccines and the recombinant zoster vaccine (RZV/Shingrix), may be administered concomitantly with, or at any time before or after, other inactivated vaccines without interference. 1, 2
Key Supporting Evidence:
- Both COVID-19 vaccines and RZV are inactivated vaccines that do not interfere with immune responses to each other 1, 2
- A cohort study found no significant difference in herpes zoster risk among individuals who received RZV with versus without concomitant vaccination 1, 2
- There is no required waiting period between COVID-19 and RZV vaccines since both are inactivated 2
Practical Administration Guidelines
How to Administer:
- Administer both vaccines at the same visit in separate anatomic sites (different injection locations, preferably different limbs) 1, 2, 3
- Do not mix vaccines in the same syringe 2, 3
- Monitor for 15-30 minutes post-vaccination as standard practice 2
Important Distinction:
RZV (Shingrix) is the recombinant, inactivated shingles vaccine and is now the preferred vaccine for most adults ≥50 years. 2 This is different from ZVL (Zostavax), which is a live attenuated vaccine that would require a 4-week interval if not given simultaneously with other live vaccines 1
Expected Reactogenicity
Patients should be counseled that they may experience more pronounced local and systemic reactions when receiving both vaccines simultaneously. 1, 2
- Although immune responses are adequate when vaccines are given on the same day, adverse reactions were more frequently reported when vaccines were co-administered 1
- Most reactogenicity symptoms resolve within 4 days 1
Special Populations
Immunocompromised Patients:
- Can receive both vaccines even while on active treatment 2
- Should receive RZV (not the live ZVL vaccine) 2
Cancer Patients:
- Can receive both vaccines even while on active treatment 2
Critical Pitfalls to Avoid
Do not delay either vaccine to administer them separately – the benefits of timely protection outweigh concerns about simultaneous administration, and delaying creates missed opportunities for protection 2, 3
Do not confuse RZV (recombinant, inactivated) with ZVL (live attenuated) – RZV is the preferred vaccine and can be given with COVID-19 vaccines without any waiting period 2
Do not assume a waiting period is needed – since both are inactivated vaccines, they can be given on the same day or at any interval 1, 2