{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:40:30Z","timestamp":1787611230837,"version":"build-2736575974"},"reference-count":51,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T00:00:00Z","timestamp":1577750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>The growing number of available vaccines that can be potentially co-administered makes the assessment of the safety of vaccine co-administration increasingly relevant but complex. We aimed to synthesize the available scientific evidence on the safety of vaccine co-administrations in children by performing a systematic literature review of studies assessing the safety of vaccine co-administrations in children between 1999 and 2019, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifty studies compared co-administered vaccines versus the same vaccines administered separately. The most frequently studied vaccines included quadrivalent meningococcal conjugate (MenACWY) vaccine, diphtheria and tetanus toxoids and acellular pertussis (DTaP) or tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccines, diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B, inactivated poliovirus and Haemophilus influenzae type b conjugate (DTaP-HepB-IPV\/Hib) vaccine, measles, mumps, and rubella (MMR) vaccine, and pneumococcal conjugate 7-valent (PCV7) or 13-valent (PCV13) vaccines. Of this, 16% (n = 8) of the studies reported significantly more adverse events following immunization (AEFI) while in 10% (n = 5) significantly fewer adverse events were found in the co-administration groups. Statistically significant differences between co-administration and separate administration were found for 16 adverse events, for 11 different vaccine co-administrations. In general, studies briefly described safety and one-third of studies lacked any statistical assessment of AEFI. Overall, the evidence on the safety of vaccine co-administrations compared to separate vaccine administrations is inconclusive and there is a paucity of large post-licensure studies addressing this issue.<\/jats:p>","DOI":"10.3390\/vaccines8010012","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T07:40:55Z","timestamp":1577778055000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Safety of Co-Administration Versus Separate Administration of the Same Vaccines in Children: A Systematic Literature Review"],"prefix":"10.3390","volume":"8","author":[{"given":"Jorgen","family":"Bauwens","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Basel, 4056 Basel, Switzerland"},{"name":"University of Basel Children\u2019s Hospital, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis-Henri","family":"Saenz","sequence":"additional","affiliation":[{"name":"Brighton Collaboration Foundation, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annina","family":"Reusser","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Basel, 4056 Basel, Switzerland"},{"name":"University of Basel Children\u2019s Hospital, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nino","family":"K\u00fcnzli","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Basel, 4056 Basel, Switzerland"},{"name":"Swiss Tropical and Public Health Institute, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Bonhoeffer","sequence":"additional","affiliation":[{"name":"University of Basel Children\u2019s Hospital, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"h5966","DOI":"10.1136\/bmj.h5966","article-title":"Visualising childhood vaccination schedules across G8 countries","volume":"351","author":"Doshi","year":"2015","journal-title":"BMJ"},{"key":"ref_2","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2017, December 25). 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