COVID-19 and Shingles Vaccination Guidelines

Introduction to Simultaneous Administration

The Centers for Disease Control and Prevention (CDC) recommends that COVID-19 and shingles vaccines can be safely administered at the same time, given at separate anatomic sites 1

Inactivated vaccines, including RZV and COVID-19 vaccines, may be administered concomitantly with, or at any time before or after, other inactivated vaccines or live vaccines protecting against a different disease, as stated by the Journal of Microbiology, Immunology and Infection 1
Both COVID-19 vaccines and RZV are inactivated vaccines, which do not interfere with immune responses to each other, according to the Journal of Microbiology, Immunology and Infection 2, 3, 1
A cohort study found no significant difference in herpes zoster risk among individuals who received RZV with versus without concomitant vaccination, as reported by the Journal of Microbiology, Immunology and Infection 2, 3

Administer both vaccines at the same visit in separate anatomic sites (different injection locations, preferably different limbs if possible), as recommended by the CDC 5, 6
Use different arms when feasible to minimize confusion about local reactions, as suggested by the Praxis Medical Insights 5
Do not mix vaccines in the same syringe, according to the Praxis Medical Insights 7, 6
Monitor for 15-30 minutes post-vaccination as standard practice, as recommended by the Praxis Medical Insights 5

Although immune responses are adequate when vaccines are given on the same day, adverse reactions were more frequently reported when vaccines were co-administered, as noted by the Journal of Microbiology, Immunology and Infection 4, 2, 3, 1
Patients should be counseled that they may experience more pronounced local and systemic reactions when receiving both vaccines simultaneously, according to the Journal of Microbiology, Immunology and Infection 2, 3
Cancer patients can receive both vaccines even while on active treatment, as stated by the Journal of the National Comprehensive Cancer Network 8, 5
Immunocompromised patients should receive RZV (not the live ZVL vaccine), as recommended by the Journal of Microbiology, Immunology and Infection 1

There is no required waiting period between COVID-19 and RZV vaccines since both are inactivated, as reported by the Journal of Microbiology, Immunology and Infection 1, 6
Delaying vaccination to separate doses is not recommended, as this creates missed opportunities for protection, according to the Praxis Medical Insights 7, 6

Do not delay either vaccine to administer them separately – the benefits of timely protection outweigh concerns about simultaneous administration, as stated by the Praxis Medical Insights 7, 6
Do not confuse RZV (recombinant, inactivated) with ZVL (live attenuated) – RZV is now the preferred vaccine for most adults ≥50 years, according to the Journal of Microbiology, Immunology and Infection 1, 8