And while we’re still waiting for similar studies with COVID-19 vaccines, there’s good reason to believe the same effects would apply, says University of Sydney associate professor of exercise science Kate Edwards, who has extensively researched the links between vaccines and exercise.
Exercise and your immune system
First, it’s important to understand the profound effects of exercise on the immune system. One, Edwards says, is that it puts more immune cells – which kill infected cells and produce antibodies to destroy viral and bacterial antigens – on patrol in the body’s blood circulation. Also, when you work out, your muscles release signalling molecules, called myokines, that help put our body’s defences on high alert. Over the long-term, regular exercise means having a stronger, more responsive immune system.
And this has had repercussions during the pandemic. A US study, published this week in the British Journal of Sports Medicine, examined almost 50,000 patients and concluded that aside from old age or a past organ transplant, physical inactivity was the biggest risk factor for severe symptoms. People who didn’t exercise were more than twice as likely to be hospitalised compared to those who clocked up at least 150 minutes of activity every week. They were also 2.5 times more likely to die of the infection.
The effects of exercise on vaccines
Given all this, it’s perhaps unsurprising that exercise has been shown to improve the efficacy of vaccines. “We see that regular exercise over the course of weeks or months makes vaccine responses stronger and that likely then means you are more protected from the disease,” Edwards says.
A study published last year found that elite athletes had significantly more anti-influenza immune cells after a flu shot compared to other healthy adults. This echoed a 2019 study finding that older adults who trained regularly had a much higher antibody response to healthy adults who didn’t exercise. Consistent exercise after a vaccine is also thought to prolong enhanced protection.
“Vaccination does cause an immune response but because we have more of these immune cells [when we exercise], it’s a much more powerful response,” says Rob Newton, professor of exercise medicine at Edith Cowan University.
Interestingly, exercising on the day of a vaccine has also shown benefits. There’s less evidence for this, Edwards says, but her research suggests it may lead to a stronger immune response, particularly from doing arm movements in the hours before injection.
“You are likely to get more immune cells moving to pick up the vaccine … but also by exercising the muscles where you’ll get the vaccine means you release those immune signals and so it may draw the cells to that location as well.”
“The key is that exercise has no downsides. It gives benefits regardless and the evidence is so strong in a range of other vaccines.”
Professor Rob Newton
What’s even more startling is that being active close to the time of a vaccination – such as flu or HPV – has been found to reduce the risk of suffering from adverse reactions to the jab. Edwards says the effects were observed simply with 15 minutes of moderate resistance band exercise, probably because the immune system was primed and ready for a challenge.
“I would expect exercise in the hour before vaccination and the short period after would have the same effect,” Edwards says. This may be particularly valuable for people who are compromised through age or illness, Newton says.
Preparing for your COVID-19 vaccine
Of course, while this is all compelling evidence, Newton says we can’t be sure the same will apply to COVID-19 vaccines, particularly those that use new mRNA technology, such as Pfizer. “But those pathways still require the involvement of the immune system and the activation of immune cells,” Newton says. “[And] exercise distributes immune factors through the body.”
Newton is frank when he explains how he’ll approach his own COVID-19 vaccine: “I’m already exercising regularly and when it’s my turn to get a vaccination I can tell you I’ll be exercising before I head off to the medical clinic.” He suggests people follow his lead: “The key is that exercise has no downsides. It gives benefits regardless and the evidence is so strong in a range of other vaccines.”
“If you’re particularly worried about a vaccine working well, then exercise is a really good thing to do, but remember it’s important for … all sorts of things.”
Associate Professor Kate Edwards
Edwards agrees: “Certainly what we’ve never seen is exercise making anything worse: immune response or side-effects.” Edwards says because researchers are still exploring why some people are experiencing COVID-19 vaccine side-effects, she recommends not drastically changing your exercise routine on the day of your shot. But if you typically go for a run or do yoga, go for it.
She says it may help to do some light arm exercises close to the time of injection – for example a few sets of wall push-ups, shoulder presses and bicep curls. “Then you might want to consider having a rest day the day after the vaccination because reactions are sometimes being seen 24-48 hours after.”
And while you wait for the rollout to reach you, it’s worth ensuring you have a training routine in place. Australia’s physical activity guidelines for adults aged 18-64 are to have at least 150 minutes of moderate exercise each week, and two resistance training sessions – the latter of which Edwards particularly recommends for promoting immune function.
The bottom line, though, is working out is good for everybody, for myriad reasons. “If you’re particularly worried about a vaccine working well, then exercise is a really good thing to do, but remember it’s important for chronic disease, mental health, socialisation, all sorts of things,” Edwards says.
Newton says people shouldn’t worry that vigorous exercise will stress their bodies. “Unless you’re an elite athlete it’s very difficult to exercise to excess and compromise your immune system.” He recommends older Australians or people with chronic illness set up an exercise program with the guidance of an accredited exercise physiologist.
By: Sophie Aubrey
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