Can Bexsero and Flu Vaccine Be Given Together?
Yes, Bexsero (MenB-4C) and influenza vaccine can be safely administered together at the same visit, using separate anatomic sites. 1, 2
Evidence Supporting Simultaneous Administration
The CDC/ACIP explicitly supports simultaneous administration of inactivated vaccines, including meningococcal and influenza vaccines, as this approach produces satisfactory antibody responses without increasing adverse reactions. 2 The fundamental principle is that inactivated vaccines do not interfere with immune responses to other inactivated vaccines when administered at separate anatomical sites. 1, 2
Key Supporting Evidence:
Both vaccines are inactivated, eliminating concerns about vaccine interference that might occur with live vaccines. 2
Pneumococcal and influenza vaccines (both inactivated, like Bexsero) can be administered simultaneously at different sites without increasing side effects, establishing precedent for this practice. 1, 2, 3
Studies demonstrate that approximately one-third of vaccine-preventable cases could have been prevented if vaccines had been administered simultaneously rather than delayed. 2
Proper Administration Protocol
Site Selection:
Administer both vaccines at separate anatomic sites, preferably different limbs (e.g., one in each arm). 2
If using high-dose or adjuvanted influenza vaccines, inject in a different limb from Bexsero to minimize local reactions. 2
Technical Requirements:
Never mix vaccines in the same syringe unless specifically FDA-approved for mixing. 2
Prepare both vaccines for administration at the same visit. 2
Observe the patient for 15 minutes post-vaccination as standard practice. 2
Clinical Benefits of Same-Day Administration
Simultaneous administration is particularly important when a patient is unlikely to return for future vaccinations, as this approach increases compliance, reduces implementation costs, and eliminates missed vaccination opportunities. 2
Common Pitfalls to Avoid
Do not delay vaccination to administer vaccines separately when they can be given simultaneously—there is no medical justification for this delay. 2, 4
Do not mix vaccines in the same syringe unless specifically approved by the FDA. 2
Do not use the same anatomic site for multiple vaccines; always use separate injection sites. 2
Special Considerations for Bexsero
While Bexsero has been associated with more solicited systemic adverse events (particularly fever) in infants when coadministered with routine infant vaccines, the vaccine's reactogenicity profile is generally acceptable. 5 This does not contraindicate simultaneous administration with influenza vaccine, but providers should counsel patients about the possibility of increased local and systemic reactions when multiple vaccines are given together. 5