Is It Safe to Get Multiple Vaccines at Once or Better to Space Them? - Everyday Health

Vaccines have changed modern medicine, leading to an impressive 99 percent decline in the incidence of more than a dozen potentially deadly diseases, according to the World Health Organization (WHO). And the innovations keep coming.

Now, in addition to a yearly flu shot, a reformulated COVID-19 vaccine and booster targeted to the latest circulating variants will be offered this fall. Plus, if you're 60 or older, you're eligible for a new seasonal vaccine to protect against RSV (respiratory syncytial virus), which can cause severe and even life-threatening disease in seniors and other vulnerable groups.

But let's face it: Scheduling individual appointments for all these vaccines — not to mention other adult vaccines recommended by the Centers for Disease Control and Prevention (CDC), such as the shingles vaccine and a tetanus or Tdap shot — is a hassle.

One way to simplify the matter is to get two vaccines at the same time — or even three. But is it safe? Do vaccines become less effective if you bundle them? And what about side effects? Keep reading for answers to all your questions about getting multiple vaccines at a single visit to the doctor or pharmacy.

Is It Safe to Get Multiple Vaccines at Once?

Experts say it's fine to multitask your vaccines. "Theoretically, there's not a maximum number of vaccines you can get at the same time if you're willing to have sore arms — you could get four or five together," says Sten Vermund, MD, PhD, professor of public health, infectious disease epidemiologist, and pediatrician at Yale Medicine in New Haven, Connecticut.

Ana Weil, MD, MPH, researcher and infectious disease specialist with UW Medicine in Seattle, agrees, saying that, "We have no reservations from a medical standpoint. There's no upper limit to how many you can get at one time."

In fact, certain scenarios require this approach, says Dr. Weil. "For example, in a medical situation where a person is going to have a compromised immune system in the future, they need to get a lot of vaccines at one time," she says.

What would getting multiple vaccines at once look like in practice? Say you're in your fifties, go this fall for your flu shot and COVID-19 booster, and wonder if you could also request the shingles vaccines recommended by your doctor or pharmacist: You could get all of those vaccines at the same time, confirms Dr. Vermund.

And if you're in your sixties and want to get your flu, COVID-19, and RSV shots in one fell swoop, that's safe too.

Are Vaccines Less Effective When You 'Bundle' Them?

A vaccine doesn't become less potent when it's delivered in a group of immunizations, says Vermund. "They are equally effective whether you give them together or separately. The immune system sees the different protein fragments [used in traditional vaccines], or mRNA fragments [utilized in certain COVID-19 vaccines], as separate from each other," he says.

"Our immune system is designed to sort all this out," Vermund says. On an average day, the body might be exposed to multiple allergens, viruses, or bacteria, he explains, and a healthy immune system is able to recognize and mount some level of defense against each.

What Are the Benefits of Getting 2 or More Shots in the Same Visit?

Studies suggest that the convenience of bundling vaccines makes this approach appealing among people of all ages. "The reality is that people are busy with jobs or school," Vermund says. Research shows that scheduling and remembering to get recommended vaccines are often cited as reasons that children and adults don't get needed shots.

"Our recommendation medically is often that people get the vaccines they need at the same time; that's the most likely path to getting the vaccine. Even when a person intends to get all the recommended vaccines, not 100 percent of people are going to follow up," says Weil.

"If you get a COVID vaccine and the flu vaccine on the same visit, it's far more convenient," says Vermund. Add in the new RSV vaccine for adults, if you are eligible, and "You could get all three of those at once," says Vermund.

"That goes for the pneumococcal vaccine, the tetanus vaccine — all the most common adult vaccines can be given at once or in any combination," he says.

What if You Don't Want to Get Multiple Vaccines at Once?

The question of whether to bundle vaccines is a personal choice, says Weil. "If people would like to space vaccines out, of course, that's their prerogative to do so. Even if we recommend that people get the vaccines at the same time, people should do what makes the most sense for them," she says.

Does Getting Multiple Vaccines at the Same Time Worsen Side Effects?

The reality is that vaccines often have side effects, says Vermund. "A sore arm is the No. 1 side effect, which is typically a reaction of the body to the ingredients of a vaccine. Different people react differently to vaccines; many people have minimal to no substantial reaction, and others have a more robust reaction," he says.

If you receive multiple vaccines at the same time, any side effects you might have could all occur at the same time, says Weil. "It doesn't mean that those side effects are worse from an individual vaccine, but if they happened at the same time, you can imagine that that might cause more symptoms," she says.

If you have a history of having strong reactions and uncomfortable side effects with vaccines, you may want to space your vaccines out rather than getting two or more at once, says Vermund.

For those who are eligible for an RSV vaccine, getting that before other seasonal vaccines would make sense, says William Schaffner, MD, professor of medicine in the division of infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee. "That's because the data indicate that the protection it provides should extend through the entire winter and may well even extend into the next winter season," he says.

Should I Get Shots in Different Arms if Getting More Than One?

Two shots, two arms? That all depends on your preference, says Vermund. "Some people find it less painful to do one in each arm, but others are reluctant to have a sore left arm and a sore right arm at the same time," he says.

If one of your shots is a COVID-19 booster, a recent study published in the journal eBioMedicine found that the immune response is stronger if you get it in the same arm as your previous COVID-19 vaccine.

Is It Okay to Treat Any Side Effects From Vaccines?

"An ice pack is a tried-and-true measure to reduce local inflammation. That is a way of reducing the inflammation and pressure in the arm and often adequate to relieve discomfort," says Vermund.

For more generalized symptoms, NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin), acetaminophen (Tylenol, others), and aspirin can be used as directed by your provider, he says. "Some people report feeling overall fatigue after the COVID vaccine. In that case get some rest and typically you'll feel better by the next day," says Vermund.

Serious side effects from vaccines are extremely rare, affecting often only 1 or 2 people out of one million vaccine doses, according to the U.S. Department of Health and Human Services.

Signs of a severe allergic reaction can include difficulty breathing, swelling of the face and throat, a fast heartbeat, a bad rash all over the body, and dizziness and weakness. If you experience this type of reaction after a vaccine, call 911 or go to the nearest hospital.

Do I Really Need to Get So Many — or Really, Any — Vaccines?

Perhaps because there's no one alive today who can remember a world before vaccines existed, the protection that immunization gives us can often be taken for granted as part of modern life.

"Many of us in the medical community think vaccines are the No. 1 technology that has reduced mortality for adults and children in the 20th century," says Vermund.

"And coming into the 21st century we're equally enthusiastic because we have some new technologies that are quite effective at confronting diseases that we previously weren't able to combat via vaccination," he adds.

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