Administering Allergy Shots After Influenza Vaccination

General Guidelines

The Advisory Committee on Immunization Practices (ACIP) recommends that inactivated vaccines, such as influenza vaccines, do not interfere with the immune response to other inactivated vaccines or to live vaccines, and can be administered simultaneously or at any interval before or after other vaccines 1.
Influenza vaccines may be administered simultaneously with other vaccines, and there is no required waiting period between inactivated vaccines, as stated by the ACIP 1, 2.
The American Academy of Pediatrics suggests that patients should not have moderate-to-severe acute illness at the time of either injection, but mild upper respiratory symptoms or allergic rhinitis do not contraindicate either procedure 3, 4.

The American College of Physicians recommends proceeding with allergy shots the day after flu vaccination if the patient did not experience an immediate allergic reaction to the flu vaccine, and does not have moderate-to-severe acute illness with fever 5, 6, 4.
The American Academy of Family Physicians suggests that normal injection site soreness or mild systemic symptoms, such as low-grade fever, fatigue, or myalgia, are expected non-allergic reactions that do not contraindicate allergy immunotherapy 5, 7.
Allergy shots should be deferred if the patient developed true allergic symptoms after the flu vaccine, or has developed moderate-to-severe febrile illness, as recommended by the American College of Physicians 5, 6.

The American Academy of Family Physicians advises not to confuse normal post-vaccination reactions, such as injection site soreness lasting up to 2 days, with contraindications to allergy shots, which affects 10-64% of flu vaccine recipients 5, 7.
Systemic symptoms, such as fever, malaise, or myalgia, beginning 6-12 hours after flu vaccination and lasting 1-2 days, are normal inflammatory responses, not allergic reactions, as stated by the American Academy of Family Physicians 5, 7.