Trevor James
The pneumococcal vaccine is a vaccination against pneumococcal disease, a bacterial infection that can cause severe and sometimes deadly illnesses such as pneumonia, bloodstream infections, and meningitis. The influenza vaccine, commonly known as the flu shot, is an annual vaccination that helps prevent the flu. While it is generally safe to administer both vaccines simultaneously in adults, there are some considerations regarding the order in which they should be given, especially in children.
| Characteristics | Values |
|---|---|
| Administering pneumococcal vaccine and influenza vaccine together | Clinicians may give pneumococcal conjugate vaccine at the same time as an influenza vaccine for adults. However, there is an increased risk of febrile seizures in children if a pneumococcal conjugate vaccine is administered with an inactivated influenza vaccine. |
| Administration of pneumococcal vaccine | Administer pneumococcal polysaccharide vaccine (PPSV23) intramuscularly or subcutaneously. Administer pneumococcal conjugate vaccines (PCV15, PCV20) intramuscularly. |
| Administration of influenza vaccine | Influenza vaccines can be administered with other vaccines such as COVID-19 and RSV vaccines. |
| Pneumococcal vaccine dosage | The primary series of PCV15 or PCV20 consists of 3 doses routinely given at 2, 4, and 6 months of age. CDC recommends a fourth (booster) dose at 12 through 15 months of age. |
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What You'll Learn
- Children may be at higher risk of febrile seizures if both vaccines are administered together
- In adults, both vaccines can be administered during the same visit
- The vaccines should be administered with separate syringes and at different injection sites
- The flu vaccine is important for preventing pneumococcal disease
- The vaccines can be administered simultaneously or sequentially
Children may be at higher risk of febrile seizures if both vaccines are administered together
Febrile seizures refer to seizures or convulsions associated with a fever in children. Children between the ages of 6 and 59 months are most susceptible to febrile seizures, with the most common age range being 14–18 months.
Children may experience febrile seizures after receiving vaccinations, including the influenza and pneumococcal vaccines. A CDC study of children aged 6 months to 2 years showed a small increased risk for febrile seizures during the 24 hours after receiving both the inactivated influenza vaccine and the pneumococcal 13-valent conjugate (PCV13) vaccine. The risk of febrile seizures was found to be higher for children aged 12 to 23 months.
However, it is important to note that the overall risk of febrile seizures is small, with at most 30 febrile seizures occurring per 100,000 children vaccinated. Vaccinating children at the recommended age may also help prevent some febrile seizures by protecting them against diseases that can cause fever and seizures.
While there is a small increased risk, clinicians may still administer the pneumococcal conjugate vaccine and the influenza vaccine simultaneously. The decision to administer both vaccines together should be made after considering the benefits of vaccinating children against influenza and pneumococcal infections.
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In adults, both vaccines can be administered during the same visit
In adults, the influenza vaccine and the pneumococcal vaccine can be administered during the same visit. This is also referred to as co-administration or simultaneous administration of vaccines, which is a common clinical practice.
The pneumococcal vaccine can be administered to adults in the form of PCV15, PCV20, PCV21, or PPSV23. The PCV21 vaccine is administered intramuscularly using the deltoid muscle, with a needle length appropriate for the adult's size. The PPSV23 vaccine can be administered intramuscularly or subcutaneously.
The influenza vaccine is also administered to adults intramuscularly, with the annual vaccination helping to prevent the flu. It is important to receive the flu vaccine as having the flu increases the risk of contracting pneumococcal disease.
While co-administration is generally safe, there are some exceptions. For instance, the pneumococcal conjugate vaccine (PCV15, PCV20, or PCV21) and PPSV23 should not be administered during the same visit. If both vaccines are indicated, PCV15 should be administered first, followed by PPSV23 after at least a year.
Additionally, while it is safe for adults to receive the influenza vaccine and other vaccines, such as COVID-19 and RSV vaccines, during the same visit, there may be a slightly higher likelihood of experiencing mild reactions such as fatigue, headache, and muscle aches.
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The vaccines should be administered with separate syringes and at different injection sites
The pneumococcal vaccine can be administered at the same time as the influenza vaccine for both children and adults. However, it is important to administer each vaccine with separate syringes and, if possible, at different injection sites. This is especially important for children, who may be at an increased risk for febrile seizures if the pneumococcal conjugate vaccine is administered with the inactivated influenza vaccine.
For infants and young children, the vastus lateralis muscle in the anterolateral thigh is the recommended injection site. In contrast, for older children and adults, the deltoid muscle is the preferred site. It is also essential to consider the length of the needle and adjust it according to the age and size of the person receiving the vaccine.
The CDC provides specific guidelines for the pneumococcal vaccine, recommending a series of three doses for infants at 2, 4, and 6 months of age, with a fourth booster dose at 12 through 15 months. The minimum interval between doses for children under 12 months is four weeks, and for those 12 months and older, it is recommended to separate doses by at least eight weeks.
For adults, the CDC recommends administering the pneumococcal vaccine (PCV15, PCV20, PCV21, or PPSV23) during the same visit as the influenza vaccination. However, it is important to note that the pneumococcal conjugate vaccine (PCV15, PCV20, or PCV21) and PPSV23 should not be administered during the same visit. If both vaccines are indicated, PCV15 should be given first, followed by PPSV23, with an interval of at least eight weeks for children and at least one year for adults.
The co-administration of vaccines is a common clinical practice, aiming to ensure individuals are up to date with their vaccinations during a single visit, especially if they may not be able to return for additional vaccinations. This practice has been studied in various age groups, including elderly individuals, and has been found to be safe and effective in most cases.
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The flu vaccine is important for preventing pneumococcal disease
Pneumococcal disease is caused by bacteria that can infect different parts of the body and is a leading cause of serious illness in people of all ages. It is caused by bacteria (Streptococcus pneumoniae) that can infect different parts of the body. When these bacteria invade the lungs, they can cause pneumonia; when they invade the bloodstream, they can cause bacteremia (which can lead to sepsis); and when they invade the lining of the brain, they can cause meningitis. These serious conditions often require hospitalisation and can even lead to death.
The flu vaccine can be administered at the same time as the pneumococcal vaccine for both children and adults. However, it is important to note that children may be at increased risk for febrile seizures if a pneumococcal conjugate vaccine is administered with an inactivated influenza vaccine. Therefore, it is recommended that each vaccine be administered with a separate syringe and, if possible, at a different injection site.
The CDC recommends routine pneumococcal vaccination for all children younger than 5 years old. The primary series of PCV15 or PCV20 consists of three doses routinely given at 2, 4, and 6 months of age, with a fourth (booster) dose recommended at 12 through 15 months of age. For children vaccinated when they are younger than 12 months old, the minimum interval between doses is four weeks. The CDC also recommends pneumococcal vaccination for children and adults at increased risk for pneumococcal disease.
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The vaccines can be administered simultaneously or sequentially
The influenza vaccine and pneumococcal vaccine can be administered simultaneously or sequentially. The CDC recommends that children should not be given a pneumococcal conjugate vaccine and an inactivated influenza vaccine together as this may increase the risk of febrile seizures. However, in the absence of such contraindications, the two vaccines can be administered during the same visit.
In adults, a pneumococcal vaccine (PCV15, PCV20, PCV21, or PPSV23) can be administered during the same visit as an influenza vaccination or other recommended vaccines. Each vaccine should be administered with a separate syringe and, if possible, at a different injection site.
There is clinical research supporting the simultaneous administration of pneumococcal and influenza vaccines. One study compared the adverse reaction rates and antibody responses when the two vaccines were given simultaneously and separately. Another study looked at the immunogenicity and safety of an inactivated quadrivalent influenza vaccine administered with a 23-valent pneumococcal polysaccharide vaccine in adults aged 60 years and older.
Simultaneous administration of vaccines is common clinical practice and is done to ensure that individuals are up to date on all their vaccines, especially if they are unable to return for additional vaccinations at a later time.
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Frequently asked questions
Yes, the influenza vaccine and the pneumococcal vaccine can be administered together. However, children may be at an increased risk for febrile seizures if a pneumococcal conjugate vaccine is administered with an inactivated influenza vaccine.
The CDC recommends a primary series of PCV15 or PCV20 consisting of 3 doses routinely given at 2, 4, and 6 months of age. A fourth (booster) dose is recommended at 12 through 15 months of age.
Everyone 6 months and older should get a flu vaccine every season with rare exceptions.
There may be an increased risk of adverse reactions such as fatigue, headache, and muscle ache when the flu vaccine and pneumococcal vaccine are administered together. However, these reactions are typically mild and go away quickly.
