COVID-19 and influenza vaccines at the same visit

01

Who may benefit most

Vaccination is particularly relevant for people at higher risk of severe COVID-19, including:

• Adults aged 65 or older
• People with chronic heart disease, such as heart failure or coronary artery disease
• People with chronic lung disease, such as COPD or interstitial lung disease
• People with chronic kidney disease, including people receiving dialysis
• People with diabetes
• People whose immune function is reduced by illness or treatment, such as during cancer treatment, after an organ transplant or while taking immunosuppressive medicines

COVID-19 vaccination is also recommended for people younger than 65 with these risk factors. Please ask us whether vaccination is appropriate and when it should be scheduled during treatment.

Japanese Association for Infectious Diseases recommendations, September 2026 (Japanese)

02

A US study of nearly 300,000 people

A study published in The New England Journal of Medicine (NEJM) in 2025 used US Veterans Affairs health records to examine the association between 2024–2025 COVID-19 vaccination and subsequent COVID-19-associated emergency visits, hospitalizations and deaths.

Follow-up lasted up to 180 days from vaccination. Using an influenza-vaccinated comparison group helps reduce differences related to vaccination habits and use of health care.

All participants had received at least one 2023–2024 COVID-19 vaccine dose. The study therefore assessed the additional benefit of the updated seasonal dose, rather than comparing vaccination with never having been vaccinated.

Participants in the influenza-only group who later received a COVID-19 vaccine were censored at that time. The comparison does not mean that everyone in that group remained without the updated vaccine for the entire 180 days.

NEJM original article: methods and Fig. 1

03

How did the estimated risks differ?

After statistical adjustment for differences such as age and medical conditions, the group receiving both vaccines had lower estimated risks of COVID-19-associated emergency visits, hospitalizations and deaths.

For hospitalization, the estimated risks were 19.06 versus 11.55 per 10,000 people, an absolute difference of about 7.5 per 10,000. The estimated relative reduction was about 39%.

These are estimates adjusted for differences between the groups, rather than simple counts divided by the number of participants. They are not a prediction of an individual patient’s chance of hospitalization.

The composite outcome counts the first occurrence of any of the three outcomes. It is not the sum of the three separate counts, since one person may experience more than one event.

*Death was defined as death within 30 days after a positive SARS-CoV-2 test, without restriction by cause. Other causes may be included if that condition is met; deaths without a qualifying positive test are not counted in this endpoint. The study did not evaluate adverse events or vaccine-attributable deaths and cannot determine safety or the overall effect on all-cause mortality.

NEJM original article: Table 2 and Fig. 2

04

Safety and limitations of the study

Influenza and COVID-19 vaccines may be given at the same visit when the doctor considers it medically appropriate. This can reduce the number of visits needed for vaccination.

Reactions may include pain at the injection site, fatigue, headache or fever. Some studies report more temporary reactions with coadministration, so we review your health and previous reactions before vaccination.

Rare serious allergic reactions and myocarditis or pericarditis have also been reported. Seek prompt medical attention for chest pain or difficulty breathing after vaccination.

Japan Ministry of Health: coadministration and adverse reactions (Japanese) / Japanese Association for Infectious Diseases recommendations (Japanese)

The NEJM study described here did not evaluate adverse events.Safety assessment requires separate clinical trials and safety studies.

This was an observational study using health records, not a randomized trial. Participants were about 71 years old on average and about 92% were male. Residual differences between groups may remain after adjustment, and the estimates may not apply to all patients in Japan. Effectiveness also varies with circulating variants and time since vaccination.

The study did not compare same-day vaccination with receiving both vaccines on separate days.It therefore does not establish that same-day vaccination is more effective than separate-day vaccination.

NEJM original article: limitations

05

Fees, questions and appointments

All listed amounts include tax.

For eligible routine-program recipients aged 65 or older who are registered residents of Miyazaki City, patient contributions for fiscal year 2026 are:

Influenza vaccine

¥1,500

COVID-19 vaccine

¥4,500

Both vaccines at the same visit

Total ¥6,000

The routine COVID-19 vaccination period is October 1, 2026 through March 31, 2027. Recipients of public assistance are exempt from both contributions on presentation of their certificate.

The routine program also includes residents aged 60–64 with specified severe heart, kidney or respiratory impairment that profoundly limits daily activities, or HIV-related immune impairment that makes daily life almost impossible. A medical recommendation does not by itself establish eligibility for the public program.

For other patients, we explain eligibility and costs individually. If your registered residence is outside Miyazaki City, check your municipality’s current program.

Miyazaki City fiscal year 2026 vaccination program (Japanese) / Clinic fees

Tell reception or your doctor that you would like influenza and COVID-19 vaccines at the same visit. We review your medical conditions, treatment, vaccination history and previous reactions, then explain scheduling and appointment arrangements.

Please also tell us if you recently had COVID-19 and when it occurred. We discuss whether and when to vaccinate in light of your health and treatment.

This page provides general patient information. Individual suitability for vaccination is assessed during consultation.