Concurrent Covid-19 and flu shots unlikely to clash
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DURBAN - ALTHOUGH there is insufficient evidence on getting the Covid-19 and flu shots together, doctors and professors say it is safe provided the necessary precautions are followed.
A health-care worker who had received the Johnson and Johnson (J&J) vaccine when the roll-out started in KwaZulu-Natal said her and her colleagues wanted to know whether it was safe to also get the flu vaccine.
She said they were worried the vaccines might have negative effects on their health.
Sisonke Study co-principal investigator Professor Ameena Goga said they had reviewed the UK Joint Committee on vaccination and immunisation, and the committee stated that while no data for co-administration of the Covid-19 and other vaccines exists, in the absence of such data, first principles suggest that interference between inactivated vaccines with different antigenic content is likely to be limited.
Goga said based on experience with other vaccines, any potential interference is most likely to result in a slightly attenuated immune response to one of the vaccines. There is no evidence of any safety concerns, although it may make the attribution of any adverse events more difficult.
Due to the absence of data on co-administration with Covid-19 vaccines, it should not be routine to offer appointments to vaccines concurrently (at the same time).
“Based on current information about the first Covid-19 vaccines being deployed, scheduling should ideally be separated by an interval of at least seven days to avoid incorrect attribution of potential adverse events.
“As all of the early Covid-19 vaccines are considered inactivated (including the non-replicating adenovirus vaccine), where individuals in an eligible cohort present having received another inactivated or live vaccine, Covid-19 vaccination should still be considered. The same applies for other live and inactivated vaccines where Covid-19 vaccination has been received first or where a patient presents requiring two vaccines,” explained Goga.
South African Medical Association chairperson Dr Angelique Coetzee said there was no order in getting the vaccines. The most important thing was that 14 days should be between the administering of the two vaccines and they can also be taken far apart. The vaccines will not clash with each other because they are two different vaccines.
Coetzee said it was safe and good practice to have both vaccines providing there was a time-lapse between the two, otherwise you might get severe reactogenic side-effects.
She said if one had Covid, then they would need to wait at least 30 days before taking the J&J or Pfizer vaccines.
“Ideally, over-60-year-olds should get both vaccines, as well as people suffering from chronic disease, as this would lessen your chances of ending up in hospital with severe flu, Covid or both,” said Coetzee.
She said the flu vaccine gives protection two weeks post vaccination and the J&J vaccine after 28 days.
National Institute for Communicable Diseases medical epidemiologist Dr Sibongile Walaza said currently there was no safety data on the co-administration of the two vaccines. The recommendation was that the vaccines should be given more than 14 days apart. If they are given within 28 days, it is recommended that they are given in opposite arms, which is important for monitoring local side-effects.
“It is important to take the influenza vaccine especially for persons who are at increased risk for severe influenza illness and/or complications. In addition, some of these individuals are also at increased risk for severe Covid-19,” said Walaza.
University of Cape Town and chief executive of the Desmond Tutu HIV Foundation, Professor Linda-Gail Bekker, said it was possible to take both vaccines but suggested they be separated by 28 days if possible to try to differentiate the reactogenicity (mild side-effects that occur following each).