Are Vaccines Tested Together?

If you are on the Fence about vaccines, one issue that might have you scared is that the idea that vaccines aren’t tested together.

So maybe they tested the Prevnar vaccine, but did they test it with the Hib vaccine?

And did they test the Prevnar and Hib vaccine with the Pediarix vaccine?

After all, kids get all of those vaccines at their two, four, and six month well child checkups.

Vaccines Are Tested Together

It is not hard to find evidence that most combinations of vaccines are in fact tested together.

For example (and this is not a complete list):

• Rotarix was tested with Pediarix (DTaP-HepB-IPV), Prevnar, and Hib
• Prevnar 13 was tested with DTaP, IPV, hepatitis B and Hib
• Prevnar 13 was tested with MMR, Varicella, and hepatitis A
• MenC with DTaP-IPV-HepB-Hib
• MenC with MMR
• MMR and Varicella with Hib, Hepatitis B, and DTaP
• hepatitis A and hepatitis B with either MMR or DTaP-IPV-Hib
• HPV vaccine for babies
• Flumist with MMR and Varicella
• Kinrix (DTaP-IPV) with MMR and Varicella
• HPV9 with Tdap and Meningococcal vaccines
• Tdap with influenza vaccine
• Meningococcal vaccine with influenza vaccine

And even after a vaccine is added to the immunization schedule and it is given together with other vaccines, our post-licensure vaccine safety monitoring systems, from VAERS to the Vaccine Safety Datalink, kick in to make sure that they are indeed safe and effective.

The Myth That Vaccines Aren’t Tested Together

If it is clear that vaccines are in fact tested together, then why do some folks still believe that they aren’t?

Hopefully everyone sees the irony in Dr. Bob saying something about vaccines being untested, as he is infamous for pushing his own made up and completely untested alternative vaccine schedule.

“Babies get as many as 6 or 7 vaccines altogether…and the CDC is admitting that they don’t always research them that way.”

Dr. Bob Sears on Fox & Friends Vaccines: A Bad Combination?

When did they admit that???

“We’ve researched the flu vaccine in great detail and it seems safe when it’s given alone, but the CDC has never researched the flu vaccine when you give it in conjunction with all the other infant shots…and that’s what we’re worried about. ”

Dr. Bob Sears on Fox & Friends Vaccines: A Bad Combination?

So, what about the flu vaccine?

While most kids get their flu vaccine by itself, just before the beginning of flu season, some might get it when they see their pediatrician for a regular checkup, at the same time they are due for other vaccines.

Not surprisingly, Dr. Bob was wrong, and several studies have shown that the flu vaccine can be safely given with other vaccines.

And don’t forget, any problems with co-administration of vaccines would show up in post-licensure vaccine safety testing.

That’s how a very small increased risk of febrile seizures was found during the 2010-11 flu season in toddlers who received either DTaP or Prevnar and a flu shot at the same time.

The very small extra risk doesn’t mean that you still can’t get the vaccines at the same time if your child needs them all though. Remember that febrile seizures “are temporary and do not cause any lasting damage.”

It will be even more reassuring to some parents that another study “examined risk of febrile seizures (FS) after trivalent inactivated influenza vaccine (TIV) and 13-valent pneumococcal conjugate vaccine (PCV13) during the 2010-2011 influenza season, adjusted for concomitant diphtheria tetanus acellular pertussis-containing vaccines (DTaP)” and found no extra risk for febrile seizures.

“Vaccines can generally be co-administered (i.e. more than one vaccine given at different sites during the same visit). Recommendations that explicitly endorse co-administration are indicated in the table, however, lack of an explicit co-administration recommendation does not imply that the vaccine cannot be co-administered; further, there are no recommendations against co-administration.”

Summary of WHO Position Papers – Recommendations for Routine Immunization

Also remember that “there are no recommendations against co-administration of vaccines,” unless of course, you are getting your advice from Bob Sears…

 

What To Know About Vaccines Being Tested Together

Vaccines are thoroughly tested for both safety and efficacy and they are also tested in many of the different combinations on the routine childhood immunization schedule.

More On Vaccines Being Tested Together

• Dr. Bob Sears and Fox & Friends
• CDC – Multiple Vaccines and the Immune System
• Vaccine Trials: Methods and Best Practices
• Are the recommended childhood vaccine schedules evidence-based?
• Vaccine Development, Testing, and Regulation
• The Development of the Immunization Schedule
• Combining childhood vaccines at one visit is not safe? Wrong, wrong, wrong!
• Do Combination Vaccines or Simultaneous Vaccination Increase the Risk of Adverse Events?
• Vaccines aren’t tested – myth vs. science
• WHO – Summary of WHO Position Papers – Recommendations for Routine Immunization
• Study – Safety of vaccines used for routine immunization of U.S. children: a systematic review
• Study – Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults
• Study – Post licensure surveillance of influenza vaccines in the Vaccine Safety Datalink in the 2013-2014 and 2014-2015 seasons
• Study – Febrile Seizures After 2010-2011 Trivalent Inactivated Influenza Vaccine
• Study – Signal identification and evaluation for risk of febrile seizures in children following trivalent inactivated influenza vaccine in the Vaccine Safety Datalink Project, 2010-2011
• Study – Post-Licensure Surveillance of Trivalent Live-Attenuated Influenza Vaccine in Children Aged 2-18 Years, Vaccine Adverse Event Reporting System, United States, July 2005-June 2012
• Study – Post-licensure surveillance of quadrivalent inactivated influenza (IIV4) vaccine in the United States, Vaccine Adverse Event Reporting System (VAERS), July 1, 2013-May 31, 2015
• Study – Coadministration of RIX4414 oral human rotavirus vaccine does not impact the immune response to antigens contained in routine infant vaccines in the United States
• Study – Antibody responses to routine pediatric vaccines administered with 13-valent pneumococcal conjugate vaccine
• Study – Safety and immunogenicity of coadministering a combined meningococcal serogroup C and Haemophilus influenzae type b conjugate vaccine with 7-valent pneumococcal conjugate vaccine and measles, mumps, and rubella vaccine at 12 months of age
• Study – Concomitant administration of a fully liquid, ready-to-use DTaP-IPV-HB-PRP-T hexavalent vaccine with a meningococcal serogroup C conjugate vaccine in infants
• Study – Safety and immunogenicity of a measles, mumps, rubella and varicella vaccine given with combined Haemophilus influenzae type b conjugate/hepatitis B vaccines and combined diphtheria-tetanus-acellular pertussis vaccines
• Study – Coadministration of a 9-Valent Human Papillomavirus Vaccine With Meningococcal and Tdap Vaccines
• Study – Immunogenicity and safety of human papillomavirus -16/18 AS04-adjuvanted vaccine coadministered with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine and/or meningococcal conjugate vaccine to healthy girls 11 to 18 years of age: results from a randomized open trial
• Study – Immunogenicity and safety of a combined hepatitis A and B vaccine administered concomitantly with either a measles-mumps-rubella or a diphtheria-tetanus-acellular pertussis-inactivated poliomyelitis vaccine mixed with a Haemophilus influenzae type b conjugate vaccine in infants aged 12-18 months
• Study – The investigational meningococcal serogroups A, C, W-135 and Y tetanus toxoid conjugate vaccine (ACWY-TT) and the seasonal influenza virus vaccine are immunogenic and well-tolerated when co-administered in adults
• Study – Safety and immunogenicity of concurrent administration of live attenuated influenza vaccine with measles-mumps-rubella and varicella vaccines to infants 12 to 15 months of age