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Is it better to vaccinate against COVID and flu together, or separately?
visibility comment0 event October 16, 2026 timer 11:04
The target groups for these two jabs are not exactly the same.
Pixel-Shot/ShutterstockAs autumn sets in and temperatures fall across the northern hemisphere, vaccination campaigns are getting underway. Vaccination is not just the most effective way to prevent severe forms of infection and avoid hospital admissions – it also protects health systems, preventing them from becoming overburdened when annual case numbers reach their peak.
The viruses that cause flu and COVID are constantly evolving, meaning we gradually lose any immunity we have acquired over time. The vaccines used in each campaign are therefore specifically formulated and adapted each year, in response to the most recent variants identified by the World Health Organization’s global surveillance and monitoring networks.
Contrary to popular belief, the primary aim of vaccination programmes is not to prevent infection. Instead, they aim to reduce the severity of the disease, the risk of hospitalisation, admission to intensive care units, and deaths among those at higher risk of complications.
At the height of the pandemic, populations were vaccinated against COVID en masse. Today, however, the strategy has changed. Vaccination campaigns now focus on protecting specific, vulnerable groups, and on optimising healthcare system resources.
However, the people vulnerable to COVID infection are not exactly the same as those who need protection against the flu.
Separate vaccination campaigns?
In Spain, the main aim of COVID vaccination is to prevent severe illness. It is, accordingly, recommended for people aged 70 and over, residents of care homes and their carers, pregnant women, people aged 12 and over with underlying health conditions, and those aged 6 months and over who are at high risk or immunocompromised.
It is recommended that members of these target groups receive one dose of the COVID vaccine, regardless of previous doses or the number and severity of previous infections.
There are certain critera though. A person can only receive the vaccine if they have not had a previous vaccine dose – or documented COVID infection – within the last 3 months. Immunocompromised people aged 6 months and over may require additional doses.
Flu vaccination works in a similar, but not identical way, as it aims to protect individuals against severe forms of the disease and to reduce community transmission.
For this reason, it lowers the age threshold to those aged 60 and over, and includes groups not covered by the general COVID vaccination programme: young children (aged 6 to 59 months) and essential service workers. It shares the COVID programme’s recommendation for people with underlying health conditions, pregnant women and healthcare workers.
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A single dose of flu vaccine is administered to the target population groups, except for premature babies and immunocompromised individuals, who may require special protocols.
Given these differences, there is debate as to whether flu and COVID vaccination programmes should still be combined, or whether they should be run separately.
The calendar plays a part here. There is a distinct winter “flu season”, with epidemic waves between November and February.
COVID, on the other hand, has a much more erratic seasonal pattern. Spikes in COVID cases are the result of new variants emerging, and the gradual loss of herd immunity. This means year-round spikes – even at the height of summer – are relatively normal.
The benefits of double vaccination
Despite the differences in how the two viruses behave, flu and COVID vaccines are still administered during the same appointment for a number of reasons.
The first is pure efficiency. It simplifies logistics, optimises staff time, and avoids the need for multiple trips to the health centre. This is particularly important for those who face greater difficulties in accessing healthcare systems, such as older women, carers and people with disabilities.
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Administering them together also ensures a higher vaccination rate among the groups for whom both recommendations apply (particularly people aged 70 and over who live in care homes).
The safety of co-administering vaccines has, of course, been amply demonstrated. Studies have shown that administering both vaccines together, injecting each one in different arms, is safe and does not reduce the immune response to either the flu or the COVID vaccine.
Vaccines benefit everyone
New variants of either virus can still get around our defences, meaning vaccinated people can still experience cases of mild infection or reinfection.
Even so, vaccines offer protection against the risk of hospitalisation. Keeping high vaccination coverage amongst the most vulnerable people is the most effective way to protect health – both for those who are vaccinated and the people around them. It is also the best way to reduce the strain on health services.
This also protects national health services, and allows them to continue providing care during the months when the seasonal flu epidemic reaches its peak.
Vaccination must be accompanied by reminders and active outreach, advice from healthcare professionals, and transparent communication about benefits and side effects.
Removing barriers to vaccination for all target groups will help to boost confidence in vaccination, making it more likely that those most at risk will receive the vaccine. Ultimately, this is one of the most significant ways we can reduce the impact of viruses like COVID and flu.
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Ángela Domínguez García is a researcher on the PI24/00692 project funded by the Carlos III Health Institute and a collaborating researcher on European projects: Grant Agreement 101233259-SHIELD and 101233394-HEP-HOP. She is a member of the Vaccination Advisory Council of the Catalan Public Health Agency. She is the Coordinator of the Vaccines and Immunisation Working Group of the Spanish Society of Epidemiology (SEE) and a member of the SEE’s Communication Advisory Committee.Isabel Aguilar Palacio receives funding from the Carlos III Health Institute and the Government of Aragon for research projects, and from the European Commission and the Innovative Health Initiative in her capacity as an expert. She is a member of the Board of Directors of the Spanish Society of Epidemiology (SEE).Pere Godoy is a principal investigator on projects funded by the Carlos III Health Institute. He is a member of the Vaccination Advisory Council of the Catalan Public Health Agency, of the Public Health Surveillance and Vaccines and Immunisation Group of the Spanish Society of Epidemiology (SEE), and a member of the SEE’s Communications Advisory Committee. He has served as president of the SEE.
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