Aliza Hekman

Aliza Hekman, a Novant Health physician assistant in Winston-Salem who specializes in infectious diseases, has been getting a lot of questions about the COVID-19 and flu vaccines. Patients wonder if it’s safe to get them at the same time.

Not only is it safe, it’s a pretty good idea to have them administered together – in different arms. “The COVID vaccine can cause a little more soreness of the arm, so it’s recommended that you get the COVID vaccine in the non-dominant arm and the flu vaccine in the other arm,” Hekman said.

“If you're planning to take the afternoon off work – just in case you have a reaction – there would definitely be an advantage to getting them both at the same time,” she added. We asked her a few other questions related to both vaccines.

How do we know getting a flu shot and the COVID vaccine are safe?

Here’s what the Centers for Disease Control and Prevention (CDC) says: “COVID-19 vaccines may be administered without regard to timing of other vaccines. This includes simultaneous administration of COVID-19 vaccine and other vaccines on the same day.”

I didn’t have a reaction to either COVID vaccine, but I understand it can make you feel like you have the flu. Can the flu vaccine make you feel like you have the flu, too?

Yes, you could have symptoms from that, too. But they're typically milder than with the COVID vaccine.

The CDC says that other vaccines given in combination has shown that immunity is similar and side effects are similar, so there's no reason that you need to spread them apart.

People who are hesitant about the COVID vaccine – do they usually have that same hesitancy about the flu vaccine?

Yes, typically they go hand-in-hand.

An important point to make here is that both of these vaccines are so important right now. It’s recommended to get the flu vaccine before the end of October so it can start protecting you now.

If you have a provider co-administer them, you'll be fully vaccinated against both diseases – and that ensures you’re protected if there's a chance you might not come back for the other one.

For people who have not gotten the COVID vaccine, does it matter if they get the flu vaccine with the first or second dose?

It doesn't matter. But like I said, the recommendation would be to get the flu vaccine soon.

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Last year, the flu was basically nonexistent because no one was going anywhere, we masked and washed our hands constantly. But this year, are you expecting the flu to make a comeback?

There's no way to know for sure, but because local guidance is more relaxed as far as masking and social distancing this year, we expect the flu season to be worse than last year.

Is it possible to get the flu and COVID? Have you treated anybody who had both, and is that just the worst?

That could certainly happen. And it could lead to pneumonia. If we have a worse flu season this year, as we anticipate, that will likely occur. And then, there would be a high chance of being hospitalized and having serious complications if you were to have flu and COVID together.

When you have a patient who is vaccine-hesitant, what do you say to them?

It depends where they're coming from. Sometimes they're coming from a place of, “Well, I know all these people who have COVID anyway,” and I reiterate the fact that the COVID vaccine is extremely effective at preventing hospitalization and death. Even if you're seeing those breakthrough cases, the rates of (few) hospitalizations and deaths are still holding up very well with vaccines.

I tend to talk about the transmissibility, especially with the delta variant. Being unvaccinated puts you at a really high risk of getting the delta variant.


The flu vaccine is recommended for nearly everybody, right?

Everyone six months and older.

Anything else you want to add?

Yes. Many childhood vaccines are administered together so there is a lot of experience among providers and among the public of getting two or more vaccines at the same time.