A healthcare worker administers a third dose of the Pfizer-BioNTech COVID-19 vaccine at a senior living facility in Worcester, Pa., on Aug. 25, 2021. (Hannah Beier/Bloomberg)
With flu season swiftly approaching in a country already battling a resurgence of the coronavirus, experts are urging Americans to avail themselves of any and all vaccines they are eligible for — whether it's their first coronavirus vaccination, a booster vaccine dose to combat waning immunity or a flu shot.
"It's terribly important" to get both the flu and coronavirus vaccines, said William Schaffner, medical director of the National Foundation for Infectious Diseases. "They are both very nasty respiratory viruses that can make many people very, very sick."
And because the coronavirus and flu vaccines "train your immune system to protect you against completely different viruses," getting a shot that protects you against one virus will not offer any protection against the other, said Kelly Moore, president and CEO of the Immunization Action Coalition.
"It's like protecting yourself against a bee and a wasp, both of which can sting you," Schaffner said. "You've got to protect yourself against each one separately."
The Centers for Disease Control and Prevention recommends that everyone be vaccinated against the flu by the end of October. This year, that time frame overlaps with the period that many Americans may become eligible for a booster dose of the coronavirus vaccine. A proposed plan from the Biden administration recommends an extra dose be administered eight months after the second shot of either the Pfizer-BioNTech or Moderna vaccines. (Officials are waiting for more data before proposing a booster timeline for the Johnson & Johnson vaccine.)
Extra doses of coronavirus vaccine are already being administered to immunocompromised people. According to the Biden administration proposal, booster shots would become more widely available starting the week of Sept. 20, though they may initially be limited to people who received the Pfizer vaccine. Some experts disagree about the need for additional shots at this time and the World Health Organization's chief has criticized the use of boosters for healthy people. But the Biden administration appears to be going ahead with the plan, which requires authorization from federal health agencies.
As Americans prepare to roll up their sleeves again for flu vaccines and possibly coronavirus boosters, here's what experts say you need to know.
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Q: Can you get a COVID booster and a flu shot at the same time?
A: Yes. The CDC has green lit receiving the coronavirus shot and other vaccines at the same time — a change from a previous recommendation to wait a minimum of 14 days between the different vaccinations.
"Now that we have so much experience with these COVID-19 vaccines, which we didn't have when they were first introduced, we are quite comfortable saying it's fine to give them with other vaccines," Moore said.
According to the CDC, the past guidance was issued during the early stages of the coronavirus vaccine rollout "out of an abundance of caution."
"We wanted to get a very clear sense of what the side effect profile was in the real world," Schaffner said.
For now, getting two shots offers convenience: "The pro is pretty obvious, You go once and you're done and it's over with," said Gabe Kelen, an emergency medicine physician and director of the Johns Hopkins Office of Critical Event Preparedness and Response.
But there may come a day when two shots won't be necessary. In April, Moderna, the company that developed one of the messenger RNA coronavirus vaccines, announced plans to create a two-in-one shot, The Washington Post's Lindsey Bever reported.
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Q: If I get both shots, will the potential side effects be worse?
A: According to the CDC, history has shown that a vaccine's possible side effects "are generally the same when given alone or with other vaccines." Therefore, a coronavirus vaccine booster shot given at the same time as a flu shot is not expected to cause previously unknown side effects or a significantly worse reaction.
"Even though they're different technologies, you're not suddenly going to grow horns," Kelen said. "It's not going to be something wildly different."
Both the coronavirus and flu vaccines, which are typically administered in the upper arm, can cause soreness at the injection site. If, for example, you get a shot in each arm, both your arms are likely to be sore afterward, Schaffner said.
It is also "somewhat more likely" that you could experience some of the vaccines' common side effects, such as fever, headaches, body aches and other flu-like symptoms if you get the shots together, Moore said. "But in our experience giving multiple vaccines at once, it's not additive," she said. "It's not like you have double the reaction because you had two shots instead of one."
Though giving a coronavirus vaccine and a flu shot together has not been studied, experts and the CDC emphasized that the practice of vaccinating against different diseases at the same time is not new. Children, particularly infants, often get several vaccines during one visit.
What's more, although the side effects of the coronavirus and flu vaccines can be uncomfortable, "they are not dangerous or unsafe in any way," Moore said. "It's worth it to go ahead and be protected against everything you need to be protected against."
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Q: What if I want to space the shots out?
A: People who have a history of strong adverse reactions to vaccines or other reasons for not wanting to get two shots at the same time, can space out the injections if they prefer, experts said, as long as they make sure to get the vaccines within the recommended time frame.
So don't delay going in for a flu shot in order to get it at the same time as a coronavirus booster if it means waiting until the end of October has passed. "You should get the flu shot when it's a good time to get the flu shot," Schaffner said. "You don't want to put it off."
One drawback to not getting the shots together is the possibility that you will forget or delay the other shot. To avoid that, schedule an appointment to come back for the second shot when you get the first.
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Q: What if I want to get the shots at the same time?
A: If you are getting both shots at the same time, the CDC guidance for vaccine providers notes that injection sites should be separated by an inch or more or administered in different limbs if possible.
While it's not recommended to take medications before your appointment to ward off side effects because that may blunt the immune response, Schaffner suggested planning for the possibility that you might not feel well.
"If the next day you're going to be in a bowling tournament or something like that, maybe that's not the best day to get your flu shot and your COVID shot," he said.
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Q: I've never gotten a flu shot before. Should I start now?
A: It's critical, experts emphasized, to take the risks of the flu seriously and protect yourself from both viruses. "The flu kills as well," Kelen said. "It's not a trivial infection for many. ... It can take anybody's life, including children." This year's flu shots offer protection against four different flu virus strains that may be circulating. Protection from flu shots is thought to last for at least six months, according to the Immunization Action Coalition.
Flu shots are especially key for people ages 65 and older, who may have a higher risk of developing severe complications, according to the CDC. Regular vaccines are approved for use among this group, but there are also two shots — high dose and adjuvanted flu vaccines — that have been specifically designed for older people.
Getting a flu shot is extremely important this year, Moore said, because hospitals and clinics in many parts of the country are already overwhelmed by the surge in coronavirus infections due to the delta variant. "Even if you're not a person who usually gets the flu vaccine because you're willing to take your chances against the virus, this is not the year," she said. "No one should be in the hospital for a preventable condition right now."
