COVID-19 Vaccine, TB testing, and Co-administration with other Vaccines

We have received a couple emails regarding this, so passing along CDC guidelines on receiving COVID vaccine after/before flu vaccines, TB testing, etc.:

Interpretation of tuberculosis test results in vaccinated persons

Inactive vaccines do not interfere with tuberculosis (TB) test results. There is no immunologic reason to believe either a Tuberculin Skin Test (TST) (administered by intradermal placement of 0.1 cc of purified protein derivative) or blood draw for interferon gamma release assay (IGRA) would affect the safety or effectiveness of mRNA COVID-19 vaccines. We have no data to inform the impact of the COVID-19 mRNA vaccines on either TB test for infection (i.e., TST or IGRA).

For healthcare personnel or patients who require baseline TB testing (at onboarding or entry into facilities) at the same time they are to receive an mRNA COVID-19 vaccine:

  • Perform TB symptom screening on all healthcare personnel or patients.
  • If utilizing the IGRA, draw blood for interferon gamma release assay prior to COVID-19 vaccination.
  • If utilizing the TST, place prior to COVID-19 vaccination.
  • If vaccination has been given and testing needs to be performed, defer TST or IGRA until 4 weeks after COVID-19 vaccine 2-dose completion.
    • All potential recipients of COVID-19 vaccination should weigh the risks and benefits of delaying TST/IGRA with their providers.

If a facility has a concern regarding delaying the TST or IGRA, because of vaccination- then they can rely on the state waivers currently in place to delay the TB test, if necessary.

Another question we have received has been regarding CDC guidance related to co-administration with other vaccines.

Coadministration with other vaccines

Given the lack of data on the safety and efficacy of mRNA COVID-19 vaccines administered simultaneously with other vaccines, the vaccine series should routinely be administered alone, with a minimum interval of 14 days before or after administration with any other vaccine. However, mRNA COVID-19 and other vaccines may be administered within a shorter period in situations where the benefits of vaccination are deemed to outweigh the potential unknown risks of vaccine coadministration (e.g., tetanus toxoid-containing vaccination as part of wound management, measles or hepatitis A vaccination during an outbreak) or to avoid barriers or delays to mRNA COVID-19 vaccination (e.g., in long-term care facility residents or healthcare personnel who received influenza or other vaccinations prior to/upon admission or onboarding). If mRNA COVID-19 vaccines are administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.