Flu shot and shingles vaccine at same time side effects

You're eligible for the shingles vaccine when you're aged 70 to 79.

When you're eligible, you can have the shingles vaccination at any time of year.

The shingles vaccine is not available on the NHS to anyone aged 80 and over because it seems to be less effective in this age group.

Is there anyone who should not have the shingles vaccination?

There are 2 shingles vaccines available in the UK:

• Zostavax, a live vaccine given as 1 dose
• Shingrix, a non-live vaccine given as 2 doses

If Zostavax is not suitable for you, a GP or practice nurse will decide whether to offer you Shingrix instead.

You should not have the shingles vaccine if you've had a serious allergic reaction (including an anaphylactic reaction) in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella (chickenpox) vaccine.

If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.

Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.

The shingles vaccine and other vaccines

You can have a shingles vaccine at the same time as most other vaccines. But try to leave 7 days between the shingles vaccine and a coronavirus (COVID-19) vaccine, so that if you have any side effects you'll know which vaccine they were from.

Get answers to shingles vaccine frequently asked questions (FAQs).

Like all vaccines, the shingles vaccines (Zostavax and Shingrix) can cause side effects, but they're generally mild and do not last long.

Common side effects that occur in at least 1 in 10 people are:

• headache
• redness, pain, swelling, itching and warmth at the injection site
• fatigue

If any side effects carry on for longer than a few days, speak to your GP or practice nurse.

Tell your GP if you develop a rash after having the shingles vaccination.

Catching chickenpox from the shingles vaccine

Very occasionally, a person has developed chickenpox following shingles vaccination (fewer than 1 in 10,000 individuals).

Allergic reaction to shingles vaccination

There is a very small chance of a severe allergic reaction (anaphylaxis) to the shingles vaccine, as there is with other vaccines.

Anaphylaxis is very serious and potentially life-threatening, but it can be treated. All healthcare staff that deliver vaccinations are trained in this. With prompt treatment, people fully recover from anaphylaxis.

Monitoring the safety and side effects of the shingles vaccine

The Yellow Card Scheme allows you to report suspected side effects from a vaccine. It's run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).

Visit Yellow Card for further information

You can read more about the side effects of the shingles vaccine in the patient information leaflets:

• Electronic Medicines Compendium: Zostavax leaflet
• Electronic Medicines Compendium: Shingrix leaflet

Conveniently for pharmacists and their patients, both the flu shot and Shingrix (RZV) can be administered during the same clinical visit.

Several important adult immunizations are currently recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP), including influenza and herpes zoster (HZ) to protect against shingles. Conveniently for pharmacists and their patients, both the flu shot and Shingrix (RZV) can be administered during the same clinical visit.

“CDC’s general best practice guidelines for immunization advise that recombinant and adjuvanted vaccines, such as RZV, can be administered concomitantly, at different anatomic sites, with other adult vaccines,” states the ACIP’s recommendations for use of herpes zoster vaccines. “Concomitant administration of RZV with Fluarix Quadrivalent (QIV) has been studied, and there was no evidence for interference in the immune response to either vaccine or safety concerns.”

The CDC stipulates that Shingrix should be administered in a different limb from other vaccines when possible. Pharmacists should also inform patients of potential side effects related to the vaccine, which is more reactogenic than some. 

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Local reactions include pain, redness, and swelling at the injection site. Patients should be advised that systemic reactions like myalgia, fatigue, and headache may also occur. About one out of six people who get Shingrix experience side effects that prevent them from engaging in their regular activities for several days after receiving the shot, according to the CDC.

Since Shingrix is given in two doses administered two to six months apart to build full protection against shingles, patients should be reminded of the importance of receiving the second dose even if they experience side effects after the first.

Shingrix earned a preferred status recommendation from the CDC after it was approved by the FDA in 2017 for the prevention of shingles and its complications, including postherpetic neuralgia (PHN). It is recommended for use in immunocompetent adults 50 and older. 

Shingrix’s efficacy rates against HZ and PHN in clinical trials were higher than those for Zostavax (ZVL). In general usage, Shingrix has been over 90% effective in all 50-plus age groups. 

Shingrix can be used in adults regardless of prior receipt of the varicella vaccine or ZVL, and it does not require screening for a history of chickenpox. 

Evaluation of coadministration of Shingrix with other adult immunizations on ACIP’s list-including PPSV23, Pneumovax23,Tdap, and Boostrix-is ongoing.