Concomitant administration of vaccines

Concomitant administration of vaccines

Key messages General • The majority of routine vaccinations can now be administered before, after, or at the same time as your COVID-19 vaccinations.

• The exception to this is the Zostavax (shingles) vaccine where a 7-day gap before or after receiving the Pfizer COVID-19 is advised.

• This change will help ensure that routine immunisation programmes (such as MMR and HPV) can continue without disruption as we progress our COVID-19 vaccine roll out.

• The recommended standard six-week gap between dose 1 and 2 of the Pfizer COVID-19 vaccination remains.

• Our priority remains to ensure that everyone in Aotearoa age 12 and older who wishes to be vaccinated for COVID-19 can do so by the end of the year.

• The COVID-19 Vaccine Technical Advisory Group has advised that there are no additional safety concerns to offering the majority of other vaccinations around the same time as the COVID-19 vaccine, beyond each vaccine’s individual safety profile.

• It’s important to keep up to date with all vaccinations throughout your lifetime. Ask your GP or health provider to make sure you and your whānau – from your tamariki to your kaumātua – are all up to date with all vaccines, not just with the COVID-19 vaccine.

• You can also view the recommended routine vaccinations on the New Zealand Immunisation Schedule.

Additional messages for Health sector • Most vaccines included in the National Immunisation Schedule, with the exception of the Zostavax (shingles) vaccine, can be administered any time before, after or at the same time as the Pfizer COVID-19 vaccine (Comirnaty).

• The clinical advice from the COVID-19 Vaccine Technical Advisory Group is based on immunological principles and existing vaccine knowledge.

• The majority of existing vaccination programmes can continue to go ahead as planned, without COVID-19 vaccinations impacting the scheduling.

• The rollout of the Pfizer COVID-19 vaccine remains the priority vaccination for everyone over the age of 12.

• Existing national immunisation schedule providers can give other vaccines at the same time as the COVID-19 vaccine (with the exception of the shingles vaccine).

• There is currently no intent to offer vaccines other than the Pfizer COVID-19 vaccine at largescale vaccination clinics.

• Older individuals that are administered the live-attenuated Zostavax (Shingles) vaccine and the Pfizer COVID-19 vaccine at the same time could potentially have a reduced immune response to one or both of the vaccines. For that reason, a gap of at least seven days is recommended between the shingles vaccine and each dose of the Pfizer COVID-19 vaccine (Comirnaty).

• If you have any questions about vaccine delivery, please contact IMAC on 0800 466 863 for clinical advice or immunisation@health.govt.nz for questions about immunisation programmes.

Health Sector Q&A What should we be telling consumers?

You can explain to them that following advice from the COVID-19 Vaccination Technical Advisory Group, we no longer need to wait to administer routine vaccinations. Most vaccines can now be administered before, after, or at the same time as COVID-19 vaccinations. The exception to this is for the Zostavax (shingles) vaccine where a 7-day interval, before or after administering Pfizer COVID-19 vaccine is advised. You can advise them that it is important that they keep up to date with the national immunisation schedule.

Can we continue with our vaccine programmes such as HPV/MMR programmes?

Existing vaccination programmes can continue to go ahead as planned, without COVID-19 vaccinations impacting this. The exception to this is for the Zostavax (shingles) vaccine where a 7day interval, before or after administering Pfizer COVID-19 is advised Do we still need to leave a gap between COVID-19 vaccines?

The recommended six-week gap between dose 1 and dose 2 of the COVID-19 vaccinations remains.

How quickly do we implement this?

You can implement this once it has been announced publicly (date TBC), although we do understand that it might take a while to update systems and processes.

What do we do about the CIR system and the NIR/PMS systems?

You should continue to enter COVID-19 vaccine events into the CIR and any other vaccines into the NIR / PMS separately. The CIR will be updated over time but hasn't been yet (as of 23 September 2021).

Will COVID vaccination sites have other vaccines available?

No. COVID-19 vaccination sites will not have other vaccines available at present. Existing national immunisation schedule providers will give the other vaccines such as your GP or Pharmacy. If providers can offer other vaccines at the same time as giving the COVID-19 vaccine, this should be encouraged to ensure that people are up to date with their immunisation schedule.

How do I know it’s safe to receive other vaccines before, after or at the same time as the COVID-19 vaccine?

The recommendations from the Ministry of Health are based on immunological principles and existing knowledge on vaccines, as was the USA’s similar recommendation: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#Coadministration.

We initially were giving the COVID-19 vaccine separately from other vaccines so we could monitor any adverse events after COVID-19 vaccine separately from events after any other vaccine. Now the COVID-19 vaccine has now been widely used and its effects well documented and understood, separate administration for this reason is no longer needed.

Why does the Zostovax vaccine require a gap?

Older individuals that are administered the live-attenuated zoster vaccine (Zostavax) and the Pfizer COVID-19 vaccine at the same time could potentially have a reduced immune response to one or both of the vaccines.

Are there health risks associated with having my routine vaccination (such as the flu vaccine) before, after or with my COVID-19 health jab?

The Ministry of Health has recommended that it is safe to have the majority of routine vaccinations with, before or after the COVID-19 vaccination. This is already happening in other countries around the world such as the United States. CV-TAG has based its recommendations on immunological principles and existing vaccine knowledge.

What other countries are practicing this?

USA and Denmark have implemented this.