Which Vaccines Can You Get at the Same Time?

Getting vaccinated is safer than getting sick. But if you’re traveling abroad, older than 65 or plan to get vaccinated for influenza (flu) and COVID-19, the number of vaccinations you need can feel overwhelming.

What if you could get multiple vaccines in one visit — the old one-and-done approach? It’d be more convenient, but is it safe?

Primary care specialist Daniel Sullivan, MD, answers that question and explains what you need to know about getting more than one vaccine at a time.

Can you get multiple vaccines at once as an adult?

The short answer is yes. “It’s been shown both in studies and in general use that getting more than one vaccine in a day is completely safe,” says Dr. Sullivan.

Getting more than one vaccine doesn’t mean mixing all the vaccines in a single syringe and getting only one shot, though. It means you can safely get multiple, separate vaccines during one appointment.

Mixing or combining vaccines into one shot is only OK for certain formulations approved by the U.S. Food and Drug Administration (FDA). One approved combo is HepA-HepB — a single vaccination that guards adults against both hepatitis A and hepatitis B.

While it’s safe, there are still some pros and cons to weigh about getting multiple, separate shots in one visit. Let’s take a look.

Benefits of getting multiple vaccines at one time

Overall, doubling or even tripling up on vaccines offers more benefits than downsides.

“If you don’t mind getting multiple shots, you’ll be better off stacking multiple vaccines into one appointment when you can,” Dr. Sullivan says.

Check out these potential benefits of getting multiple vaccinations at once.

Increases effectiveness

Vaccines trigger your immune system to produce antibodies — proteins that recognize and attack a disease or virus.

You may wonder if your body can mount an immune response to more than one vaccine at a time. Dr. Sullivan explains that getting vaccines simultaneously is not only safe, but it also may actually make each of those vaccines even more effective.

“Getting a vaccine improves your body’s immune response,” Dr. Sullivan explains. “The second vaccine enhances that response and intensifies your ability to react to the vaccine trigger.”

He also recommends getting multiple vaccines in the same arm whenever possible. Research suggests it may encourage a stronger immune response than vaccines given in different limbs.

“When multiple vaccines target the same local lymph nodes, those lymph nodes produce more antibodies and help your body build a stronger response to the vaccine,” he adds.

So convenient

Whether you’re due for routine vaccinations or simply want to stay healthy this winter, getting the vaccines you need can be challenging if you need multiple appointments.

“Most routine vaccines for adults can be given at the same time,” Dr. Sullivan notes. “For instance, we offer the flu shot and COVID-19 vaccine together so it’s easier for patients to protect themselves without the hassle of coming back.”

Wondering how many routine vaccines you can get at once? It’s a matter of preference.

“Our nurses have given people four or more vaccines in one appointment if it’s what the patient wants and needs,” he says. “Not everyone wants that many pokes in one sitting, but it’s safe and saves your multiple trips to the office.”

Downsides to getting two vaccines in the same arm

Getting more than one shot in the same arm is safe, but it may not be ideal for everyone.

Your healthcare provider may want to give the shots in separate limbs if you are:

• Getting painful shots: TDaP (tetanus, diphtheria and pertussis) and PCV (pneumococcal conjugate, a pneumonia vaccine) commonly cause muscle soreness and some tenderness at the injection site. Getting these shots in separate arms can decrease your post-vaccine pain.
• Concerned about a bad reaction: If you’re worried about a severe reaction or have reacted badly to a previous vaccine, it may be wise to get vaccines in separate arms. If you have a reaction, you’ll know which vaccine caused it.

Which vaccines can’t be given together?

Dr. Sullivan acknowledges that there are urban legends about vaccines that you can’t get together. But most people can get most routine vaccines at the same time unless you prefer to space them out.

That is most people and most vaccines can be given in combo.

There are some circumstances that will require you to space things out.

Dr. Sullivan explains those situations.

People who are high-risk

People age 65 and older and those who are at high-risk for certain complications shouldn’t get some vaccines at the same time.

For example, people age 65 and older need two pneumococcal vaccines, PCV and PPSV23 (23-valent pneumococcal polysaccharide). But you can’t get both vaccines on the same day.

Plan to get PCV first. Then, after eight weeks, you can get PPSV23. If you mistakenly get PPSV23 before PCV, that’s OK. But you’ll have to wait a year before getting PCV.

People with certain spleen issues or HIV also have limits on how many vaccines they can get at once. If you have these conditions, plan to get pneumococcal conjugate and meningococcal vaccines at separate times.

In general, if you have health conditions or any concerns, talk to your healthcare provider about the most appropriate vaccination schedule for you.

People getting travel vaccines

Traveling abroad often requires vaccinations that aren’t routine in the United States. Certain travel vaccines can’t be given at the same time.

For example, if you need vaccines for both cholera and typhoid fever, you need to get the cholera vaccine first. You’ll then need to wait at least eight hours to get the typhoid vaccine.

People getting live vaccines

Vaccines use either a weakened (live) form of a disease or an inactivated one. Both trigger your immune system to fight off infection.

Live vaccines tend to create a stronger immune response, so you don’t want to get more than two live vaccines at the same time. Some examples of live vaccines include:

• Influenza (nasal spray).
• Measles, mumps and rubella (MMR vaccine).
• Smallpox.
• Typhoid fever (oral vaccine).
• Varicella (chickenpox).
• Yellow fever.

“You can get two live vaccines on the same day,” Dr. Sullivan says. “After that, you’ll need to wait four weeks to get another live vaccine. The spacing helps achieve the appropriate immune response.”

If you’re due for multiple vaccines and want to get them over with at once, know that in most cases you can. Talk with your healthcare provider about any risks and the most appropriate vaccine schedule for you.