Considerations with Timing of COVID-19 Vaccine and Other Vaccines and TB Testing

There has been some confusion regarding the timing of the COVID-19 vaccine with other vaccines, such as the flu shot, and with tuberculin (TB) testing. The Centers for Disease Control and Prevention (CDC) has issued guidance on both, and members should note that TB testing guidance has significant implications for onboarding of new staff.

TB testing is a requirement for new employees in many settings, and members are also urged to consider the timing of TB testing and COVID-19 vaccination when onboarding new staff. Failing to do so could result in a delay in the individual’s start date, which no provider can afford during this workforce shortage. According to CDC guidance:

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

Perform TB symptom screening on all healthcare personnel or patients.
If using IGRA, draw blood prior to COVID-19 mRNA vaccination.
If using TST, place prior to COVID-19 mRNA vaccination.
If COVID-19 mRNA vaccination has already occurred, defer TST or IGRA until 4 weeks after completion of 2-dose COVID-19 mRNA vaccination.

Members are reminded that the Department of Health (DOH) has issued new regulations regarding TB testing and screening of personnel for nursing homes, home care, and enhanced and special needs assisted living residences. The guidance does allow for a TB screening if someone has had a baseline TB test, generally within the past year. Click here for more information. It is notable that similar regulations are in development for other adult care facilities (ACFs). Again, members should be mindful of this guidance so they are not delayed in bringing in new employees.

DOH also wanted to ensure that providers know that the flu and COVID-19 vaccines can be given at the same time, though ideally at different injection sites (for example, different arms). Click here for CDC guidance on the administration of the COVID-19 vaccine with other vaccinations.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828