General Principles For Vaccine Scheduling
Optimal response to a vaccine depends on multiple factors, including the type of vaccine, age of the recipient, and immune status of the recipient. Recommendations for the age at which vaccines are administered are influenced by age-specific risks for disease, age-specific risks for complications, age-specific responses to vaccination, and potential interference with the immune response by passively transferred maternal antibodies. Vaccines are generally recommended for members of the youngest age group at risk for experiencing the disease for which vaccine efficacy and safety have been demonstrated.
Tetanus and diphtheria toxoids require booster doses to maintain protective antibody concentrations . Unconjugated polysaccharide vaccines do not induce T-cell memory, and additional doses might increase the duration of protection. Conjugation with a protein carrier improves the effectiveness of polysaccharide vaccines by inducing T-lymphocytedependent immunologic function . Many vaccines that stimulate both cell-mediated immunity and neutralizing antibodies can usually induce prolonged immunity, even if antibody titers decline over time . Subsequent exposure to such viruses usually results in a rapid anamnestic antibody response without viremia.
What Were The Results
The most common side effects that the participants reported were pain around the injection site and fatigue. Only one person experienced a rare reaction and was admitted to the hospital with a migraine.
Two vaccine combinations led to a slight increase in the number of people who reported at least one side effect when they received both of the vaccines together, but the reactions were mostly mild or moderate.
The researchers found no significant difference in four out of the six group combinations.
The study also found that the immune responses to both the influenza and COVID-19 vaccine were preserved with coadministration.
Moreover, 98.7% of the volunteers said that they would be willing to have two vaccines at the same time in the future.
The Importance Of Getting Both Vaccines
Andrew Pavia, MD, chief of the Division of Pediatric Infectious Diseases at the University of Utah Health and a spokesperson at the Infectious Diseases Society of America, tells Verywell that with flu season on its way and about 90 million Americans still unvaccinated against COVID-19, the new guidance is important because it can increase the chance that someone coming in for one of the vaccines who also needs the other, will get it.
Infectious disease experts like Pavia worry that the few flu cases that were reported last yearlikely because of the lockdown, which meant all offices and schools were closedmight lead people to believe that they do not need flu shots for the 2021-2022 season. Thats far from the case, however.
We just dont know what the flu season will be like this year, says Pavia. And you could be risking severe illness or death, especially if you get COVID-19 at the same time, so we really need people to get both vaccines.
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Why The Recommendations Changed
Both the CDC and AAP say safety data and a need to catch up children and teens on missed vaccinations played a role.
“The AAP supports giving other childhood and adolescent immunizations at the same time as COVID-19 vaccines, particularly for children and teens who are behind on their immunizations, the AAPs statement reads. Between the substantial data collected on the safety of COVID-19 vaccines, and the extensive experience with non-COVID-19 vaccines which shows the immune response and side effects are generally similar when vaccines are given together as when they are administered alone, the benefits of co-administration and timely catch up on vaccinations outweigh any theoretical risk.
Woodworth also said that updated co-administration recommendations may facilitate catch up vaccination of adolescents. She cited data that showed the administration of many other vaccines has declined during the pandemic.
Specifically, vaccine orders from providers were down 11.7 million doses as of May 2, 2021 when compared with 2019. The gap was largest in vaccines usually given to teens, including:
- The Tdap vaccine
- HPV vaccine
- Meningococcal conjugate vaccine
Will We Ever Have A 2

Pairing flu shots with the one-shot Johnson & Johnson vaccine, a second dose of an mRNA vaccine, or a booster, will make vaccination appointments one and done for many people.
In the future, the process could be even more streamlined. As soon as next year, you might be able to get the flu and COVID-19 shots as a single jaban advancement that will hopefully improve the uptake of both vaccines.
At least one company, Novavax, is working on a combination vaccine. In June, that the vaccine being tested may be a viable immunization strategy. While those results were promising, the study has yet to be peer-reviewed.
These results demonstrate the promising opportunity for vaccination, which may improve the uptake of both vaccines, said Gregory M. Glenn, MD, president of research and development at Novavax.
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When To Get The Flu Shot
Flu season typically runs from late fall to early spring.
Flu shots are now available for all Ontarians. You should get a flu shot as soon as possible because it takes two weeks to take effect.
The National Advisory Committee on Immunization now recommends that COVID-19 vaccines may be given at the same time as the flu vaccine.
Talk to your doctor or pharmacy to learn more.
What Side Effects Should I Look Out For
Side effects vary from vaccine to vaccine, according to Privor-Dumm.
According to the U.S Department of Health and Human Services website Vaccine.org, common issues include:
- Soreness at the injection site
- A low-grade fever
- Muscle aches
- Fatigue
In very rare cases, you may be allergic to the ingredients in a vaccine or have another severe reaction. If you feel sick in any way after receiving a shot, call your doctor, Privor-Dumm says.
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A Flu And Pneumonia Vaccine Reminders Injections
Flu and pneumonia vaccine season is fast approaching. Here are some reminders:
- 13.59A may be claimed in addition to a visit when the physician provides a visit service in accordance with the Governing Rules.
- In order to claim for more than one injection at the same encounter simply change the number of calls to the appropriate number. If more than two injections are provided at the same encounter, text must be added to the claim.
- For injections provided in the physicians office Injections for flu or pneumonia may be claimed as 13.59A when the nurse provides the injections . A visit service may not be claimed in addition to a nurse-provided injection unless the physician has provided a visit service in accordance with the Governing Rules. Nurse-provided injections in the hospital may not be submitted by a physician to Alberta Health for payment.
- The only injections that are billable to Alberta Health when they are provided by the nurse are for flu, pneumonia and allergy desensitization . All other injections must be provided by the physician in order to submit a claim to Alberta Health.
For more advice from AMA staff on any billing issues, including explanations of recent billing changes, please .
Disclaimer: this tool has been produced by the AMA solely as a convenient reference and the official Government ofAlberta statutes and regulations must be consulted for all purposes of interpreting and applying the law. © Alberta MedicalAssociation 2021 | Privacy Policy
Side Effects Of The Pneumococcal Vaccine In Babies
Mild side effects of the pneumococcal conjugate vaccine , which is the version of the pneumococcal vaccine given to babies under the age of 2, include:
- a decreased appetite
- redness and swelling at the site of the injection
- feeling sleepy or not sleeping well
Serious side effects of the PCV vaccine are rare, and include:
- a high temperature, possibly leading to convulsions
- allergic reactions, such as an itchy skin rash
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Add A Comment4 Comments
I had a senior flu shot in 2015 at 4:30 pm. About 12 hours later I woke up with a severe headache and pain starting under my left arm going across my chest. I thought I was having a heart attack. It was so fraightening I have not gotten one since. I am 88 years old.
I had a flu shot at 9 AM and at 11 AM that same day I experienced chest heaviness. I was not short ofbreath or having chest pain just chest heaviness I also at that time was experiencing a severe headache . Are these symptoms possible side effects?
Common side effects of the flu shot include:Soreness, redness, and/or swelling from the shot.Headache.
Signs of a severe allergic reaction can include:Difficulty breathingSwelling around the eyes or lipsHivesWeaknessA fast heartbeat or dizzinessLife-threatening allergic reactions to the flu shot are rare. These signs would most likely happen within a few minutes to a few hours after the vaccine is given.
We can’t know if chest heaviness is related to the flu shot, it might be, though it’s not listed above. Check with your doctor.
Helena
When To Get The Vaccine
Thereâs no such thing as pneumonia season, like flu season. If you and your doctor decide that you need to have a pneumonia vaccine, you can get it done at any time of the year. If itâs flu season, you can even get a pneumonia vaccine at the same time that you get a flu vaccine, as long as you receive each shot in a different arm.
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Unknown Or Uncertain Vaccination Status
Vaccination providers frequently encounter persons who do not have adequate documentation of vaccinations. With the exception of influenza vaccine and PPSV23, providers should only accept written, dated records as evidence of vaccination self-reported doses of influenza vaccine and PPSV23 are acceptable . The rationale for acceptance for influenza vaccine is that the time period of recall is one year or less, making it very likely that correct recall will occur. The rationale for acceptance for PPSV23 is high frequency of vaccination leads to an increased rate of local reactions due to the reactogenicity of this vaccine. Although vaccinations should not be postponed if records cannot be found, an attempt to locate missing records should be made by contacting previous health care providers, reviewing state or local IISs, and searching for a personally held record. If records cannot be located within a reasonable time, these persons should be considered susceptible and started on the age-appropriate vaccination schedule. Serologic testing for immunity is an alternative to vaccination for certain antigens . However, commercial serologic testing might not always be sufficiently sensitive or standardized for detection of vaccine-induced immunity , and research laboratory testing might not be readily available.
Based on expert opinion.
TABLE 3-1. Recommended and minimum ages and intervals between vaccine doses,,,
What Are The Pros And Cons Of Being Vaccinated

The benefits of vaccination generally far outweigh any risks, Privor-Dumm says. Although vaccines do have some side effects, most are mild and temporary.
The bigger con is getting disease, which may lead to further health complications, she adds. For instance, people who are hospitalized with influenza have a greater likelihood of heart attack or stroke following their illness, and the economic consequences of a serious illness can be catastrophic for some. Thats why its best to prevent disease in the first place.
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Pneumococcal Vaccination And Coronavirus
No, the pneumococcal vaccination does not involve a vaccine against COVID-19. Coronavirus disease is caused by a virus. Pneumococci are bacteria. The pneumococcal vaccination protects you against the 23 most common types of pneumococci.
If you are invited, it is advisable to get the pneumococcal vaccination as well. COVID-19 vaccination does not protect you against pneumococci. You have been offered the pneumococcal vaccination because your age means that you have a higher risk of becoming seriously ill if you get pneumococcal disease.
No. The respiratory symptoms that can affect your lungs due to COVID-19 are caused by the coronavirus SARS-CoV-2 and not by pneumococci. The pneumococcal vaccination only protects you against pneumococcal bacteria.
The most common side-effects after the pneumococcal vaccination are pain at the injection site, feeling tired, irritability or reduced appetite. After the pneumococcal vaccination, you may also develop flu-like symptoms, such as headache, elevated temperature, muscle aches, diarrhoea or abdominal pain. That usually goes away within 2 days.
Spacing Of Multiple Doses Of The Same Antigen
Vaccination providers should adhere to recommended vaccination schedules . Administration at recommended ages and in accordance with recommended intervals between doses of multidose antigens provides optimal protection.
Administration of doses of a multidose vaccine using intervals that are shorter than recommended might be necessary in certain circumstances, such as impending international travel or when a person is behind schedule on vaccinations but needs rapid protection. In these situations, an accelerated schedule can be implemented using intervals between doses that are shorter than intervals recommended for routine vaccination . The accelerated or minimum intervals and ages for scheduling catch-up vaccinations. Vaccine doses should not be administered at intervals less than these minimum intervals or at an age that is younger than the minimum age.*
Certain vaccines produce increased rates of local or systemic reactions in certain recipients when administered more frequently than recommended . Careful record keeping, maintenance of patient histories, use of immunization information systems , and adherence to recommended schedules can decrease the incidence of such reactions without adversely affecting immunity.
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Pneumococcal Disease In Children
In children, the most common manifestation is bacteraemia without focus. This accounts for approximately 70% of IPD, followed by pneumonia with bacteraemia.
Meningitis is the least common but most severe category of IPD
- irritability
- seizures
Acute otitis media is the most common non-invasive manifestation of pneumococcal disease in children. Streptococcus pneumoniae is detected in 2855% of middle ear aspirates from children with acute otitis media.34,38,39
Pneumococcal disease in adults
In adults, pneumonia with bacteraemia is the most common manifestation of IPD
- more than one-third of all community-acquired pneumonia
- up to half of hospitalised pneumonia in adults
However, it is difficult to accurately determine the proportion attributable to pneumococci in cases of non-bacteraemic pneumonia.
Symptoms of pneumonia include:
- chest pain
What To Know About Mild Side Effects
As with any vaccine, you may experience some mild side effects after receiving the pneumococcal vaccine.
Mild side effects vary depending on which vaccine you receive. The side effects will usually go away within a few days.
Possible side effects of the PCV13 vaccine include:
- redness or discoloration, pain, or swelling at the site of the shot
- sleepiness or drowsiness
- mild fever
On very rare occasions, serious side effects can occur, such as high fever, convulsions, or a skin rash. Contact your childs pediatrician right away if you notice any of these symptoms.
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Injection Route And Injectionsite
Injectable vaccines are administered by intramuscular, intradermal, and subcutaneous routes. The method of administration of injectable vaccines depends in part on the presence of an adjuvant in some vaccines. The term adjuvant refers to a vaccine component distinct from the antigen, which enhances the immune response to the antigen. Vaccines containing an adjuvant should be injected into a muscle mass, because administration subcutaneously or intradermally can cause local irritation, induration, skin discoloration, inflammation, and granuloma formation. Detailed discussion and recommendations about vaccination of people with bleeding disorders or receiving anticoagulant therapy are available in the ACIP general best practices guidelines for immunization.
Routes of administration are recommended by the manufacturer for each immunobiologic. Deviation from the recommended route of administration may reduce vaccine efficacy or increase local adverse reactions. Detailed recommendations on the route and site for all vaccines have been published in ACIP recommendations a compiled list of these publications is available on the CDC website at www.cdc.gov/vaccines/hcp/acip-recs .
Side Effects Of The Pneumococcal Vaccine In Adults And Older Children
Mild side effects of the pneumococcal polysaccharide vaccine , the version of the pneumococcal vaccine given to adults and children over the age of 2, include:
- mild soreness or hardness at the site of the injection lasting 1 to 3 days
- a slightly raised temperature
More serious side effects of the PPV vaccine, such as allergic reactions, are rare.
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What Happens If You Have A Flu Vaccine And A Covid
- What happens if you have a flu vaccine and a Covid-19 booster at the same time?
When we published our updated MEA information leaflet on Covid-19 booster jabs, flu vaccines and pneumococcal vaccine two weeks ago I noted that there were going to be pros and cons to having both vaccines together and that we didnt have any feedback from people with ME/CFS at the time who had been given a flu vaccine and a Covid-19 booster together.
An interesting report in the Mail on Sunday today follows up some feedback from their resident GP, Dr Ellie Cannon who reported last week that she was hearing from patients who had been knocked for six after receiving a double dose.
The MoS report also includes comments from vaccine experts as to why this might be happening especially in older age groups.
A number of my friends have had the two jabs together, and felt quite poorly,’
It passes and can be managed at home with paracetamol. I’ve stocked up on painkillers in anticipation of having my booster and flu vaccines.’
Pharmaceuticals expert Professor Penny Ward of King’s College London
Prof Ward has an intriguing theory as to why some people suffering. We know that side effects can be worse after the Pfizer vaccine, and I wonder whether those who feel really rough and people who previously had AstraZeneca, and are now having their first Pfizer, as a booster.’
So please can we have your feedback positive or negative if you have had both jabs together.