Unraveling the Ultimate Dilemma: How to Determine If They Should Be Together?

Pharmacist Ani Martirosyan administers an immunization to a patient at a CVS on Tuesday, Sept. 12, 2023 in Glendale, CA. (Photo by Brian Van Der Brug | Los Angeles Times | Getty Images)

For the first time ever, vaccines for Covid, the flu, and respiratory syncytial virus (RSV) are available in the U.S. Public health officials are urging eligible Americans to take all three shots to prevent another “tripledemic” of Covid, flu, and RSV, which overwhelmed hospitals last fall and winter. However, the option of receiving three shots has raised questions about whether they should be taken together or spaced out.

For most people, the decision only involves getting an updated Pfizer or Moderna Covid shot along with a flu vaccine, as both are widely available to all Americans. Public health officials, physicians, and recent research indicate that receiving both vaccines during the same visit to the doctor or pharmacy is safe and effective.

Meanwhile, approximately 76.5 million adults aged 60 and older are eligible for a new RSV vaccine from Pfizer or GSK, which means they need to consider all three shots this fall. Although a maternal vaccine from Pfizer protects infants against RSV, it is not currently available.

Experts in the field state that there aren’t expected to be any issues with receiving all three shots together. However, they also note that there is limited research on administering an RSV shot with another vaccine or receiving all three shots simultaneously. People who prefer to do so can choose to take the RSV vaccine separately and get the other two shots at a different time. Ultimately, it is up to the individual and their personal preference, and they should consult their doctors if they are unsure.

Both Dr. Ali Alhassani from Boston Children’s Hospital and Dr. Andrew Pekosz from the Johns Hopkins Bloomberg School of Public Health believe that there is no evidence of any risk in receiving all three shots at once. Alhassani mentioned that administering multiple vaccines is common, as children often receive several routine immunizations at once. Pekosz emphasized that there likely won’t be any problems with taking them together, but without data, he is cautious about making a firm recommendation.

One significant advantage of receiving all three shots together is the convenience factor. Alhassani emphasized that the biggest benefit is the ease of receiving them all in one visit. Research shows that many people never return for their second shot, leading to incomplete vaccination. By getting all three shots during the same visit, the attrition rate is reduced.

Pharmacies like Kroger allow Americans to schedule multiple vaccine appointments in one visit. The online scheduling tool enables eligible individuals to select up to three vaccines to receive at once, with assistance from clinicians, pharmacists, and physician assistants.

However, some people may prefer to wait for more data before receiving all three shots together. Dr. Janak Patel from the University of Texas Medical Branch noted that since there is limited information on taking all three vaccines simultaneously, it may be a good idea to receive the RSV vaccine separately if uncertain.

Others may choose to receive the vaccines at different times for physical comfort. Alhassani explained that one of the most common side effects of vaccines is inflammation or soreness at the injection site. To minimize this, it is typical for individuals receiving two shots during the same visit to have one in each arm. However, some may prefer to avoid the discomfort of receiving three shots at once, especially if they engage in activities that require arm movement.

If individuals do decide to receive the three shots separately, the recommended order is to get the updated Covid vaccine first, followed by the RSV shot and then the flu jab. Dr. Pekosz suggests taking them one week apart from each other to minimize the chances of missing a shot. The updated Covid shot should take priority due to the current high levels of virus transmission. RSV cases are also increasing, while influenza is not yet widespread. Alternatively, individuals can receive their Covid and flu shots together and wait a week to receive the RSV vaccine.

In conclusion, it is crucial for individuals to make an informed decision about receiving multiple vaccines. While receiving all three shots together is generally considered safe and convenient, some may prefer to space out the vaccinations for various reasons. It is advisable to consult healthcare professionals and consider personal circumstances when deciding on the optimal approach.

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