Vaccination Administration Guidelines

General Recommendations

The Centers for Disease Control and Prevention recommends that inactivated vaccines, including the shingles vaccine, can be safely and effectively administered simultaneously with or after other vaccines like COVID-19 and influenza vaccines 1
COVID-19 vaccines can be administered concurrently with influenza vaccines, and the shingles vaccine can be added to this combination without safety concerns 1
When administering multiple vaccines simultaneously, they should be given at separate anatomic sites to minimize local reactions 1
Individual vaccines should not be mixed in the same syringe unless specifically licensed for mixing by the FDA 1

There is no need to delay vaccination to administer these vaccines separately when they can be given simultaneously or in sequence 1
If administering vaccines with increased reactogenicity, they should be injected into different limbs to minimize local reactions 1
For live vaccines, if not administered simultaneously with other live vaccines, at least 4 weeks should pass between administrations 1
Studies have shown that simultaneous administration of vaccines elicits satisfactory antibody responses without increasing the incidence or severity of adverse reactions 1

The American College of Rheumatology has identified the need to evaluate the impact of coadministration of COVID-19 vaccines given concurrently with other non-live virus vaccines on vaccine immunogenicity and tolerability 2
For patients on immunomodulatory therapies, the American College of Rheumatology provides guidance on timing vaccinations, but these recommendations do not specifically contraindicate administering shingles vaccines after COVID-19 and flu vaccines 3, 4, 5