Evidence map›Paper›PMID 41335471›Full record

SynthesisHuman vaccines & immunotherapeutics2025

Safety of co-administration of injectable vaccines in individuals under 18 years of age: A systematic literature review.

Sara Boccalini, Marco Del Riccio, Giada Crescioli, Cristina Salvati, Alice Sadotti, Costanza Cacini, Gabriele Cerini, Johanna Alexandra Iamarino, Giulia Ionita, Enrica Stancanelli and 4 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Human vaccines & immunotherapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Sara BoccaliniDepartment of Health Sciences, University of Florence, Florence, Italy.
Marco Del RiccioDepartment of Health Sciences, University of Florence, Florence, Italy.
Giada CrescioliDepartment of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Cristina SalvatiDepartment of Health Sciences, University of Florence, Florence, Italy.ORCID 0009-0001-7652-3487
Alice SadottiDepartment of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Costanza CaciniDepartment of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Gabriele CeriniMedical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy.
Johanna Alexandra IamarinoMedical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy.
Giulia IonitaMedical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy.
Enrica StancanelliMedical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy.
Giuseppe AlboraMedical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy.
Paolo BonanniDepartment of Health Sciences, University of Florence, Florence, Italy.
Alfredo VannacciDepartment of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Angela BechiniDepartment of Health Sciences, University of Florence, Florence, Italy.ORCID 0000-0002-6013-8779

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Co-administration of multiple vaccines during a single clinical visit is common in pediatric immunization programs, but administering three or more injections simultaneously has raised safety concerns. This systematic review, conducted in 2023, assessed the safety of administering three or more vaccines at the same time compared with giving fewer or the same vaccines across separate sessions. Data from 26 studies were analyzed using random-effects meta-analyses. The risk of any adverse event (AE) was modestly increased (OR ≈ 1.54), mainly due to expected and transient reactions such as fever, irritability and injection-site pain. Importantly, there was no significant increase in serious adverse events (SAEs) (OR 1.07, 95% CI 0.92-1.25). Differences in systemic (OR 1.19, 95% CI 0.95-1.50) or local AEs (OR 1.37, 95% CI 0.85-2.22) were not statistically significant. These findings support the continued co-administration of multiple vaccines in pediatric programs, providing a nuanced safety profile for policymakers and clinicians.

Indexed as

VaccinationVaccinesAdolescentChildChild, PreschoolHumansImmunization ScheduleInfantInjectionsVaccinesadolescentsAdverse eventAEFIchildrenclinical trialimmunizationvaccination

Identifiers

PMID41335471
PMCPMC12688230

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.