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What do we know about giving flu and COVID-19 vaccines together?

The flu and pneumococcal disease can lead to serious complications, including pneumonia – as can coronavirus disease (COVID-19) (1). In fact, the symptoms of COVID-19 are similar to the symptoms of the flu (1).

Last flu season, the federal government in Germany procured more than 26 million doses of flu vaccines (2). People at the highest risk of invasive pneumococcal disease were also offered pneumococcal vaccination (3). Those people included older adults over the age of 70, people with chronic diseases of the respiratory organs or the heart and people with congenital or acquired immunodeficiencies or immunosuppression (3).

In France, almost 18 million people at high risk of becoming seriously ill from the flu were invited to get their flu vaccine (4). Those people include those over 65 years of age, along with others at higher risk of flu complications. People born between 1948 and 1952 will also be offered pneumococcal vaccination, with the pneumococcal vaccination often given at the same time as the flu vaccination (4).

So, what do we know about COVID-19 vaccination this flu season? Let’s explore.

So, can flu and COVID-19 vaccines be given together?

A study among people over 60 in the Netherlands is looking into how best to combine COVID-19 and flu vaccines (5). The study started in September 2021 and will run through autumn and winter, with full results expected in the spring (5).

This particular study explores how these two vaccinations relate to each other (5). The questions it aims to answer include: Do the vaccines reinforce each other, or do they not? Which order of vaccination produces the most antibodies against COVID-19? And can we give the injections at the same time, or should there be a certain period in between?

Research completed in the UK found no decrease in the efficiency of a flu vaccine given at the same time as a COVID-19 vaccine (6). It also found only a few instances of side effects such as pain and tenderness at the injection site and muscle aches increasing (6).

What are other countries doing?

Separate healthcare visits for COVID-19 and flu vaccinations could be difficult(6) for some people; giving both vaccines simultaneously may improve the uptake of both (6). In the UK, experts have recognised the possible benefits of giving COVID-19 vaccine boosters and flu vaccines together (7). Here, everything needed for the annual flu vaccination program is already in place and could be modified to accommodate COVID-19, whatever course the pandemic takes (7).

Across Germany, a third COVID-19 vaccination is being offered to older people and those at risk, including people with weakened immune systems(8). A booster shot will also be offered to anyone who received the two-dose AstraZeneca or single-dose Johnson & Johnson vaccines (8). About eight million people are estimated to be eligible for the booster shot (9).

Across France, a third COVID-19 vaccination is being offered to those over the age of 65 and people with underlying health conditions, providing a minimum of six months has passed since they got fully vaccinated with the Pfizer or Moderna vaccine (10). Those who received the single-dose Johnson & Johnson jab can get a booster shot of Pfizer or Moderna at least four weeks after they first got vaccinated (10). About 18 million people are estimated to be eligible for the booster shot (10).

After all, there is a significant overlap in the people most at risk of complications from the two diseases (7). Countries in the EU/EEA have primarily prioritised older adults, people with certain chronic illnesses, residents and personnel of long-term care facilities, healthcare workers and social care personnel for COVID-19 vaccines (7).

Experts in the US have recommended that COVID-19 vaccines and other vaccines may be given at the same time (7). And while data on giving COVID-19 vaccines simultaneously as other vaccines is currently limited, no safety or reduced effectiveness concerns have arisen to date (7).

With less research data available when its flu season began early in 2021, Australia cautiously recommended that people wait at least seven days between their flu and COVID-19 vaccine (11). This approach allowed for proper safety and monitoring for both vaccines despite no evidence that the two vaccinations interact with each other (11).

Getting your flu vaccine this flu season is as important as ever. And you may also need your primary COVID-19 vaccines or a booster. Research results to date have indicated that it is safe to give both the COVID-19 and influenza vaccine together, meaning fewer appointments, which will make it easier to get both vaccines (12).


Sources
(1) https://www.rivm.nl/en/frequently-asked-questions-about-flu-jab-pneumococcal-vaccination-and-covid-19
(2) https://www.bundesgesundheitsministerium.de/../grippeimpfung.html
(3) https://www.lungeninformationsdienst.de/aktuelles/news/alle-news-im-ueberblick/aktuelles/article/pneumokokken-impfung-aktuelle-stiko-empfehlungen//index.html
(4) https://www.has-sante.fr/upload/docs/application/pdf/2021-05/avis_2021_0033_seesp_du_12_mai_2021_du_college_de_la_has.pdf
(5) https://www.radboudumc.nl/nieuws/2021/radboudumc-start-onderzoek-naar-combinatie-griepvaccin-en-coronabooster
(6) https://www.europeanpharmaceuticalreview.com/news/156674/co-administration-of-flu-and-covid-19-vaccines-safe-and-effective/
(7) https://www.ecdc.europa.eu/sites/default/files/documents/Interim-public-health-considerations-for-the-provision-of-additional-COVID-19-vaccine-doses.pdf
(8) https://www.euractiv.com/section/health-consumers/news/germany-to-offer-covid-booster-shots-from-september/
(9) https://www.morgenpost.de/vermischtes/article233196515/booster-impfung-corona-auffrischung-dritte-spritze.html
(10) https://www.euronews.com/2021/09/01/france-starts-giving-covid-booster-jabs-to-its-elderly-and-vulnerable
(11) https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/is-it-true/is-it-true-why-do-i-have-to-wait-7-days-between-getting-the-flu-and-covid-19-vaccine
(12) https://www.medrxiv.org/content/10.1101/2021.06.09.21258556v1

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