Tuesday, March 28, 2023

Flu Shot And Shingrix Together

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The Shot: Pneumonia Vaccine

Winter COVID-19 and Flu Vaccine Explained

How often: Depends on your health status.

What to expect: There are two versions of the vaccine PPSV23 and PCV13. Your health status and any underlying conditions determine which version you need, the number of doses, and the timeline that you should receive those doses.

The pneumonia vaccines, PCV13 and PPSV23, prevent infections that can occur from 13 to 23 types of pneumococcal bacteria respectively the efficiency of these vaccines range from 45% to 75%. The pneumonia vaccines are really most relevant for folks who are either older adultswe typically think people more than the age of 50 to 65, or those who are immunosuppressed, Dr. Wolfe says.

Most likely, you will only get the pneumonia shot once in your adulthood or, depending on your longevity, once every five years. They’re obviously less frequent. It’s a good conversation I think people should have with their physician as it comes into September or October and things are starting to cool down, Dr. Wolfe says.

Is It Cheaper To Get A Vaccine At My Doctors Office Or A Pharmacy

You may feel more comfortable getting shots at your healthcare providers office. Your provider knows your patient history and can provide a one-on-one experience. If you choose to get vaccinated at your providers office, keep in mind you may be billed for an office visit in addition to the cost of the shot.

For the COVID-19 vaccine, your provider shouldnt charge you if the vaccine was the only service you received. You should ask for a refund if you believe you were billed in error for the COVID-19 vaccine.

You can also get immunizations against flu, pneumonia, shingles, and other conditions at your local pharmacy. Youll be responsible for any copays or deductibles depending on your prescription drug plan, but you wont have an office visit copay.

Plus, your vaccine record will be kept on file as part of your permanent pharmacy history. When you get vaccinated at your pharmacy, your information is entered into the state immunization registry, which can be accessed by your doctor, Dr. Schaffner says.

Flu/shingles Shot Combo May Hurt Future Flu Vaccine Uptake

People who got the zoster vaccine the same day as their annual influenza shot were more likely to skip their flu shot the following year than people who got the two shots on separate days, according to results from a new study.

Evidence suggests that people mistakenly think adverse effects commonly related to the zoster vaccine including chills, fever, pain, and nausea are caused by the flu vaccine, researchers write in an original investigation published in JAMA Network Open.

Benjamin Rome

The work by Benjamin Rome, MD, MPH, a primary care physician from the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston, and colleagues was November 19.

The study involved 89,237 people with an average age of 72 years. Researchers used Optum’s deidentified Clinformatics Data Mart Database, a national, commercial health insurance claims database that contains information on 17 million patients with commercial insurance and Medicare Advantage plans in all 50 states.

The cohort consisted of people at least 50 years of age who received the influenza vaccine between August 1, 2018 and March 31, 2019, and received the shingles vaccine on the same day or separately in the previous 6 months.

Those who had both shots the same day were significantly less likely than those who got them on different days to get their annual flu shot the next flu season . Results were similar across subgroups.

L.J. Tan

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When It Is Given

You will receive 2 injections with an interval of 2 to 6 months.

The first injection can be given from the age of 50 years. You will be informed when you should come back for the second dose of SHINGRIX.

Make sure you finish the complete vaccination course. This will maximise the protection offered by SHINGRIX.

Shingrix Dosage And Schedule

Can You Get Both The Shingles And Flu Shot At The Same Time?

Shingrix should be administered to adults age 50 years and older as a two-dose series , 2 to 6 months apart .

If more than 6 months have elapsed since the first dose of Shingrix, you should administer the second dose as soon as possible. However, you do not need to restart the vaccine series.

If the second dose is given less than 4 weeks after the first dose, the second dose should be considered invalid. A valid second dose should be administered 2 months after the invalid dose .

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What Are Some Side Effects Of Getting A Vaccine

Common side effects for all these vaccines are mild and may include pain, swelling, or redness where the vaccine was given.

Before getting any vaccine, talk with your doctor about your health history, including past illnesses and treatments, as well as any allergies.

It’s a good idea to keep your own vaccination record, listing the types and dates of your shots, along with any side effects or problems.

Simultaneous Administration With Other Vaccines

RZV and LZV may be administered concomitantly with other live vaccines given by the parenteral, oral, or intranasal routes. For concomitant parenteral injections, different injection sites and separate needles and syringes should be used.

In general, inactivated vaccines including RZV may be administered concomitantly with, or at any time before or after, other inactivated vaccines or live vaccines protecting against a different disease.

LZV may be given at any time before or after live oral or intranasal vaccines. If two live parenteral vaccines are not administered concomitantly, there should be a period of at least 4 weeks before the second live parenteral vaccine is given.

Concomitant administration of pneumococcal 23-valent polysaccharide vaccine and LZV has not resulted in decreased efficacy and so the two vaccines can be given concomitantly.

For more information, refer to Timing of Vaccine Administration in Part 1.

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Is Vaccine Coverage Worse In The 12 States That Haven’t Expanded Their Medicaid Programs Than In Those That Have

Although it may seem that there could be less adult vaccine coverage in states that havent expanded Medicaid, that isnt the case. In fact, all of these states offer some vaccine coverage. Compared to the states that have expanded Medicaid, they dont fall behind due to the variation that still exists in those states.

For context, here are the 12 states that havent expanded Medicaid:

  • Alabama

  • Wisconsin

  • Wyoming

To give you a better idea of the variation among these non-expanded states, here are a few examples of the vaccine coverage they offer for adults:

  • Alabama Medicaid covers five of the recommended adult vaccines .

  • Mississippi Medicaid covers all 13 recommended vaccines.

  • Wyoming Medicaid provides flu shots for all adult members, but other vaccine coverage will depend on the plan you have.

More Common Side Effects

Flu Shot FAQ with Dr. Sree

The more common side effects of Shingrix can include:

  • pain, redness, and swelling at site of injection*
  • headache*
  • dizziness or fainting
  • flu-like symptoms, including fever, shivering, and tiredness

Most of these side effects may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk to your doctor or pharmacist.

* For more information about this side effect, see Side effect details below.

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How To Store Shingrix

  • Keep this medicine out of the sight and reach of children.
  • Store in a refrigerator Do not freeze.
  • Store in the original package in order to protect from light.
  • Do not use this medicine after the expiry date which is stated on the label and carton after EXP. The expiry date refers to the last day of that month.

Uncommon Rare And Very Rare Adverse Events

Uncommon adverse events occur in 0.1% to less than 1% of vaccinees. Rare and very rare adverse events occur, respectively, in 0.01% to less than 0.1% and less than 0.01% of vaccinees.

Both HZ vaccines are safe with serious adverse events reported very rarely in immunocompetent individuals.

Recurrence or exacerbation of herpes zoster ophthalmicus following LZV vaccination has been reported very rarely, involving several cases world-wide following LZV immunization. Following a causality assessment of seven cases of HZO which were temporally associated with the administration of LZV, NACI concluded that there was insufficient evidence to recommend for or against the administration of LZV in individuals with a history of HZO. More evidence is required for further assessment of risk related to HZO recurrence in LZV recipients. At this time, there is insufficient evidence to assess the risk related to HZO recurrence following RZV recipients.

See Contraindications and Precautions if considering vaccinating a person with previous HZO.

For more information, refer to Adverse events following immunization in Part 2 and the product monograph in Health Canada’s Drug Product Database.

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Tetanus Diphtheria And Pertussis Vaccines

Tetanus, diphtheria, and pertussis are serious diseases that can lead to death.

  • Tetanus is caused by bacteria found in soil, dust, and manure. It enters the body through cuts in the skin.
  • Diphtheria, also caused by bacteria, is a serious illness that can affect the tonsils, throat, nose, or skin. It can spread from person to person.
  • Pertussis, also known as whooping cough, is caused by bacteria. It is a serious illness that causes uncontrollable, violent coughing fits that make it hard to breathe. It can spread from person to person.

Getting vaccinated is the best way to prevent tetanus, diphtheria, and pertussis. Most people get vaccinated as children, but you also need booster shots as you get older to stay best protected against these diseases. The CDC recommends that adults get a Tdap or Td booster shot every 10 years. Ask your doctor when you need your booster shot.

Can Shingrix Cause A Rash

Sunalta Medical Clinic

Its unlikely that a Shingrix injection will cause a rash. But note that an injection site reaction is different from a shingles rash.

A shingles rash, which is caused by shingles itself, is often painful. It commonly appears as blisters around the torso, neck, or face.

People who received Shingrix in didnt report shingles-like rashes.


The Food and Drug Administration approves vaccines such as Shingrix to prevent certain conditions.

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What Shingrix Is Used For

SHINGRIX is a vaccine that helps to protect adults against herpes zoster as well as the long-lasting nerve pain that can follow shingles called post-herpetic neuralgia or PHN.

SHINGRIX can be given to adults from the age of 50 years and above.

What is shingles and what are the complications related to shingles?

Shingles is caused by the same virus that causes chickenpox. After you have had chickenpox , the virus that caused it stays in your body in nerve cells. Sometimes, after many years, the virus can become active again and causes shingles .

SHINGRIX cannot be used to prevent chickenpox . Shingles is a painful, blistering rash. It usually occurs in one part of the body and can last for several weeks. It may lead to complications such as long-lasting pain and scarring. Less commonly, bacterial skin infections, weakness, muscle paralysis, loss of hearing or vision can occur.

What is post-herpetic neuralgia ?

After the shingles blisters heal, pain can last for months or years and may be severe. This long-lasting nerve pain is called PHN. PHN is the most common complication of shingles.

How does the vaccine work?

SHINGRIX helps your body to build its own protection against shingles and its complications.

SHINGRIX cannot be used to treat shingles or the pain associated with shingles. It is for the protection against shingles only.

As with all vaccines, SHINGRIX may not fully protect all people who are vaccinated.

This medicine is available only with a doctor’s prescription.

Are There Different Vaccines For Medicaid

No. Medicaid vaccines are the same as youd receive through any other program or form of insurance. And Medicaid-covered vaccines are always administered by qualified professionals such as pharmacists and healthcare workers. This also applies to COVID-19 vaccines. At the height of the pandemic, some mass vaccination sites also brought in active-duty troops from the National Guard to give shots, and they were also qualified to do so.

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Im Living With Hiv Is It Safe For Me To Get Shingrix

The Centers for Disease Control and Prevention hasnt made a recommendation about the use of Shingrix in people living with HIV.

However, one study looked at healthy adults ages 18 and older who were living with HIV and had an HIV dosing schedule that was customized to their needs. These people received the Shingrix vaccine, and the study results did not report any safety issues.

If youre living with HIV, talk with your doctor about the risks and benefits of getting Shingrix.

The Shot: Seasonal Flu Or Influenza Vaccine

Can you get the flu shot and COVID vaccine at the same time?

How often: Yearly, usually in the fall.

What to expect: It is straightforwardjust a jab in the shoulder.

After hearing about the efficiency rates of the Covid-19 vaccines and their ability to stop variants, you might think that the flu vaccine has some catching up to do. The flu vaccine is maybe 50%, 60%, 70% at best, says Peter Katona, M.D., UCLA Fielding School of Public Health professor of epidemiology and of medicine at the David Geffen School of Medicine in Los Angeles.

This flu virus is a sneaky bugger that mutates with fervor. Each year, the new flu vaccine is created to protect against a strain of the flu virus that scientists believe will emerge. Some years, they guess right other years, not so much. Either way, any vaccine is better than none, priming your immune system for what might be ahead.

Generally speaking, there are almost no reasons why people shouldn’t be getting a COVID and a flu shot, Dr. Wolfe says. We know they are effective. We know that theyre safe. So, the mere fact that we can’t quite predict how busy the flu season should be, shouldn’t be a reason for folks to put their head in the sand, and think that they shouldnt do it.

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Your Good Health: Taking Flu Shot With Shingles Vaccine Might Worsen Side

Dear Dr. Roach: Is it advisable to get the Shingrix vaccine at the same time as the annual influenza vaccine?


It can be done, but whenever possible, you should get the new Shingrix vaccine by itself. The side effects of this vaccine are more pronounced than with most approved vaccines, and more people may not feel well and will have low grade fever, muscle aches and fatigue that can last a day or two. Anecdotally, it seems that getting multiple vaccines the same day may worsen that reaction. I advise patients to get the Shingrix vaccine on a day where they have nothing critical planned that day or the next, just in case.

If you havent gotten this years flu vaccine, get it right now. Today, if possible.

Dear Dr. Roach: I saw your recent article about a 57-year-old womans question about herpes, and thought it would be good to reach out to see if you could help me. I am struggling to find good information about my new condition.


I am terribly sorry you became infected. Your partner may have never known they were infected. Many people with genital herpes are unaware they have it, never having had a breakout, or not recognizing a mild breakout for what it was.

Primary care doctors have experience with genital herpes, as do all gynecologists. There are some doctors who make care of people with herpes their focus of practice and research, such as experts in infectious diseases. I recommend consultation with an expert to discuss all your concerns.

Will There Be Any Side Effects From The Shingles Vaccination

There are 2 shingles vaccines: Zostavax and Shingrix .

With both vaccines it’s quite common to get redness and discomfort at the vaccination site, headaches and fatigue, but these side effects should not last more than a few days. See a GP if you have side effects that last longer than a few days, or if you develop a rash after having the shingles vaccination.

Read more about the shingles vaccine side effects.

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Shingrix And Other Medications

Below are medications that can interact with Shingrix. These are not all the drugs that may interact with Shingrix.

Before taking Shingrix, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Immunosuppressive drugs such as prednisone

Taking Shingrix with drugs that suppress your immune system can cause problems with the way your body responds to Shingrix. Examples of immunosuppressive medications include:

  • corticosteroids, such as:

Here are answers to some frequently asked questions about Shingrix.

Dosage For Shingles Prevention

Doctors Urging People To Get The Flu Vaccine This Year

Shingrix is given as two 0.5-mL injections in your upper arm. Youll receive two doses of this vaccine.

Over time, some vaccines protection begins to fade, so may you need booster doses. They help keep the vaccine working. But you dont need a booster dose after getting the two doses of Shingrix.

Shingrix dosing schedule for people ages 50 years and older

For people ages 50 years and older taking Shingrix, the second dose is given 2 to 6 months after the first dose.

Shingrix dosing schedule for people ages 18 years and older with an increased risk of shingles

For people ages 18 years and older with an increased risk of shingles who are taking Shingrix, the second dose may be given 1 to 2 months after the first dose.

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