Simultaneous Immunizations in Adults
Are recommended by CDC with only two exceptions.
1. PCV13 and PPSV23
“In patients recommended to receive both PCV13 and PPSV23, the 2 vaccines should not be administered simultaneously. PCV13 should be administered first. If PPSV23 has been administered first, PCV13 should be administered no earlier than 8 weeks later in children 6-18 years, and one year later in adults 19 years and older.”
2. Menactra and Prevnar in patients with anatomic or functional asplenia.
“In persons with anatomic or functional asplenia, quadrivalent meningococcal conjugate vaccine (MCV4)-D (MenACWY-D, Menactra) and pneumococcal conjugate vaccine (PCV)13 (PCV13, Prevnar 13) should not be administered simultaneously. This is based on immunogenicity studies that showed reduced antibody concentrations for 3 serotypes of pneumococcus (subtypes 4, 6B, and 18C) when PCV7 was administered simultaneously with MenACWY-D. For persons with anatomic or functional asplenia, PCV13 should be administered first and MenACWY-D 4 weeks later.” CDC
All other vaccines can be given at the same time.
Reference
https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/timing.html
http://www.med.umich.edu/1info/FHP/practiceguides/adult.imms/immsguideline.pdf