Australians are being advised to wait two weeks between getting the flu jab and COVID-19 vaccine — but it doesn’t matter which one you have first, according to the Australian Technical Advisory Group on Immunisation (ATAGI).

Key points:

  • The government recommends everyone six months and older get immunised against the flu
  • The Pfizer and AstraZeneca vaccines each need two doses
  • Experts say if you are eligible for the COVID-19 jab, get that one first

This advice is based on there being two COVID-19 vaccines available to Australians early- to mid-2021: the Pfizer shot, which will be rolled out to top-tier priority groups across Australia from Monday and the AstraZeneca vaccine, which was today given the green light by the Therapeutic Goods Administration TGA).

While the ATAGI “doesn’t recommend” getting both the COVID and flu vaccines on the same day, the group said there could be circumstances where the co-administration of an influenza vaccine with a COVID-19 vaccine could be considered.

What else do you need to know about booking your vaccinations this season?

Which vaccine first?

Last month, the ATAGI released its advice on the relative timing of administering influenza and COVID-19 vaccines in 2021.

Both the Pfizer and AstraZeneca vaccines need two doses to be effective, with the Pfizer option needing to be given 21 days apart and the AstraZeneca jab 4-12 weeks apart.

The Australian Government recommends everyone aged six months and over get immunised against seasonal flu.(Reuters: Gareth Fuller/Andreas Gebert)

But the ATAGI says these jabs can be taken either side of the flu vaccine.

“There is no particular requirement regarding the order of receiving a dose of influenza vaccine and either the first or second dose of a COVID-19 vaccine,” the advice said.

Immunisation Coalition chairman Rod Pearce, who is a practising GP in South Australia, says if you are eligible for the COVID-19 jab and are offered one first, take it.

“The influenza vaccine will definitely be here in April and we should have an abundant supply because it’s manufactured here in Australia.”

Robert Booy, professor of paediatrics and child health at the University of Sydney and a senior professorial fellow at the National Centre for Immunisation Research, said older Australians should book in for the COVID-19 jab before the flu vaccine.

“It comes down to practicalities: most people who are at a high risk in the elderly or occupational, or in the chronic disease groups, should probably get COVID vaccines first,” he said.

Professor Booy said this was because the threat of coronavirus was still “relatively high”, and had a higher death rate for this age group than the flu.

But he said kids should get the influenza jab first, as children under five were of “considerably lower risk of COVID than the flu”.

“For children under five who are at risk of severe flu and are at risk of transmitting the flu to adults and other children, flu should probably come first because we don’t have a licenced vaccine for children under five,” Professor Booy said.

Both coronavirus vaccines need two doses to be effective.(Getty Images: Zinkevych)

TGA head John Skerritt recommended people in the first round of the Pfizer shot rollout, which starts on Monday, should get their COVID-19 shot first.

How long between each jab?

Dr Pearce and Professor Booy backed the ATAGI’s recommendation to have the vaccines two weeks apart.

Dr Pearce said the 14-day wait time was a precaution and would allow health workers to identify which jab was the cause of any potential side effects.

Dr Pearce used the example of a patient getting a “Pfizer vaccine in the one arm and the flu vaccine in the other”, which could theoretically lead to an unusual reaction.

He said — purely hypothetically — a patient could have a local reaction or lymph node reaction after getting the Pfizer vaccine, which could mean they didn’t have the same immune response to the influenza vaccine.

“There’s concern with any vaccines about knowing what we know and how they work and how they interact,” Dr Pearce said.

“Australia has always had a principal that any combined vaccines, any vaccines given together should be tested in Australia and we should have the evidence to know that in Australia under our conditions the vaccines don’t have less of a response.”

Adjunct Professor John Skerritt said at the moment, regulators were not seeing any “significant problems” regarding the coronavirus vaccines.

“There’s well known issues such as headache, temperature and sore arm and so forth, but nothing that seems to be really very serious,” he said.

“So at the moment, it’s recommended that you have your shots 14 days or so apart.”

Professor Booy said the immune system also needed time to respond to the vaccine, and giving Australians a two-week window would help build that response.

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The AstraZeneca COVID-19 vaccine has been approved for use in Australia.

What if you get them within the same fortnight?

If someone was to have both jabs in the same two-week window, Dr Pearce said it wouldn’t be a huge concern.

“Remember we don’t have the data, so when we don’t have the data, we are honestly saying ‘this is the issue’, but we can’t see there would be a problem, we don’t anticipate a problem and we don’t expect a lesser immune response if you have them together,” he said.

Professor Booy said while he definitely would not recommend someone having both jabs at the same time, if someone was to have them in quick succession, he urged them to make their doctor aware as it could present an opportunity to study what immunity could be offered.

Both Dr Pearce and Professor Booy said anyone who had any adverse or unusual side effects to either vaccine should report it straight away.

Waiting two weeks between each vaccine also allows the body to build an immune response.(Getty Images: South_Agency)

Will the COVID jab affect the flu shot rollout?

Government-funded flu vaccines are expected to be available in about April this year, and are free for at-risk groups, including children aged six months to five years.

Charlotte Hespe is Royal Australian College of General Practitioners NSW and ACT chairman and owns her own GP practice.

She said the rollout of the COVID-19 jab came at a difficult time for family doctors.

“For us, it’s the worst possible timing because it is right in the flu vaccine,” Dr Hespe said.

“All general practitioners will have three separate vaccinations that we need to give people at risk.”

But Dr Pearce said he didn’t expect the COVID-19 vaccine rollout to impact supply of the flu jab, as they were separate vaccines manufactured in different facilities.

“There’s no reason to think that the factory that makes the influenza vaccine is going to be affected by the COVID rollout,” he said.

Professor Booy said the rollout of both at the same time could present a “logistical challenge” for some.

Dr Hespe said Australia had seen record low numbers of flu cases during the pandemic — but it was important for Australians to stay vigilant about influenza this season.

Professor Booy agreed.

“If we let our guard down, flu will be back with a vengeance. It was very quiet last year,” he said.