Vaccine Administration Intervals: Guidelines for Different Vaccine Types

Inactivated Vaccines

Inactivated vaccines do not interfere with the immune response to other inactivated vaccines or to live vaccines, allowing flexible scheduling 1, 2
Inactivated vaccines can be administered either simultaneously or at any interval before or after different inactivated vaccines 4
Inactivated vaccines can be administered either simultaneously or at any interval before or after live vaccines 1
Examples of inactivated vaccines include influenza vaccine, pneumococcal vaccines, tetanus, diphtheria, acellular pertussis, hepatitis vaccines, and recombinant zoster vaccine 4, 5

When administering multiple live vaccines, they should either be given on the same day or separated by at least 4 weeks 1, 5, 6
If parenterally administered live vaccines are separated by less than 4 weeks, the vaccine administered second should not be counted as a valid dose and should be repeated 1, 3
The repeat dose should be administered at least 4 weeks after the invalid dose 1
Examples of live vaccines include measles-mumps-rubella, varicella, zoster vaccine live, and yellow fever vaccine 5, 6
Studies have shown that administering varicella vaccine less than 30 days after MMR vaccination resulted in a 2.5-fold increased risk for varicella vaccine failure 1

Simultaneous administration is recommended as an effective approach to increase immunization rates 4, 5
Simultaneously administered vaccines are generally safe and effective 5
MMR and varicella vaccines administered on the same day produce an identical immune response to when they are administered a month apart 7
Research shows that administering all indicated vaccines at the same visit increases the likelihood of complete vaccination and provides timely protection 7

Ty21a typhoid vaccine and parenteral live vaccines can be administered simultaneously or at any interval before or after each other 1
Yellow fever vaccine can be administered at any time after single-antigen measles vaccine 1
After receiving antibody-containing products, parenteral live vaccines should be delayed until the passive antibody has degraded 2
If a live-virus vaccine is administered after an antibody-containing product at an interval shorter than recommended, the vaccine dose should be repeated unless serologic testing indicates a response to the vaccine 2

Licensed combination vaccines can be used whenever any components of the combination are indicated and its other components are not contraindicated 8
Use of licensed combination vaccines is preferred over separate injection of their equivalent component vaccines to reduce the number of injections 8
Only FDA-approved combination vaccines should be used; individual vaccines must never be mixed in the same syringe unless specifically approved for mixing 8