Effects of Exercise and Physical Activity Levels on Vaccination Efficacy: A Systematic Review and Meta-Analysis

Author: Petros C Dinas1, Yiannis Koutedakis2,3, Leonidas G Ioannou1, George Metsios3,4,5, George D Kitas5
Affiliation: <sup>1</sup> FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece. <sup>2</sup> Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece. <sup>3</sup> Faculty of Education Health &amp; Wellbeing, University of Wolverhampton, Walsall WS1 3BD, UK. <sup>4</sup> Department of Nutrition and Dietetics, University of Thessaly, 42100 Trikala, Greece. <sup>5</sup> Dudley Group NHS Foundation Trust and School of Sports and Exercise Science, University of Birmingham, Birmingham B15 2TT, UK.
Conference/Journal: Vaccines (Basel)
Date published: 2022 May 12
Other: Volume ID: 10 , Issue ID: 5 , Pages: 769 , Special Notes: doi: 10.3390/vaccines10050769. , Word Count: 235

We examined whether different intensities of exercise and/or physical activity (PA) levels affected and/or associated with vaccination efficacy.

A systematic review and meta-analysis was conducted and registered with PROSPERO (CRD42021230108). The PubMed, EMBASE, Cochrane Library (trials), SportDiscus, and CINAHL databases were searched up to January 2022.

In total, 38 eligible studies were included. Chronic exercise increased influenza antibodies (standardized mean difference (SMD) = 0.49, confidence interval (CI) = 0.25-0.73, Z = 3.95, I2 = 90%, p &lt; 0.01), which was mainly driven by aerobic exercise (SMD = 0.39, CI = 0.19-0.58, Z = 3.96, I2 = 77%, p &lt; 0.01) as opposed to combined (aerobic + resistance; p = 0.07) or other exercise types (i.e., taiji and qigong, unspecified; p &gt; 0.05). PA levels positively affected antibodies in response to influenza vaccination (SMD = 0.18, CI = 0.02-0.34, Z = 2.21, I2 = 76%, p = 0.03), which was mainly driven by high PA levels compared to moderate PA levels (Chi2 = 10.35, I2 = 90.3%, p &lt; 0.01). Physically active individuals developed influenza antibodies in response to vaccination in &gt;4 weeks (SMD = 0.64, CI = 0.30-0.98, Z = 3.72, I2 = 83%, p &lt; 0.01) as opposed to &lt;4 weeks (p &gt; 0.05; Chi2 = 13.40, I2 = 92.5%, p &lt; 0.01) post vaccination.

Chronic aerobic exercise or high PA levels increased influenza antibodies in humans more than vaccinated individuals with no participation in exercise/PA. The evidence regarding the effects of exercise/PA levels on antibodies in response to vaccines other than influenza is extremely limited.

Keywords: influenza; vaccines and exercise; vaccines antibodies.

PMID: 35632525 DOI: 10.3390/vaccines10050769