Timing of Vaccination after Training: Immune Response and Side Effects in Athletes

Abstract

Objectives Influenza vaccination was used to assess whether induction of immunity or side effects are influenced by the timing of the last training session before vaccination. Methods Forty-five healthy athletes (36 male, 23 ± 8 yr, ≥5 training sessions per week, predominantly national competition level) were vaccinated with the tetravalent influenza vaccine; blood samples were collected immediately before and 1, 2, and 26 wk after vaccination. Athletes were randomly assigned to vaccination within 2 h after the last training session versus after 24–26 h. Influenza-specific T cells were quantified after stimulation with the vaccine based on intracellular cytokine staining. Antibodies (IgA, IgG, IgM) were quantified by enzyme-linked immunosorbent assay and neutralization assay. Participants documented resulting side effects and training restrictions using a standardized diary. Results Both groups showed an increase in influenza-reactive CD4 T-cell levels, which peaked 1 wk after vaccination (fold changes to baseline; median (interquartile range), 3.7 (3.0–5.4; P < 0.001) in the 2-h group; 4.6 (2.8–7.4; P < 0.001) in the 26-h group) with no difference between groups (P = 0.52). Influenza-specific antibodies showed a significant increase after vaccination in both groups (at least 1.4-fold, each P < 0.001, no group differences; P = 0.24–0.97 for different antibody types). Only antibodies toward the Brisbane strain showed a trend toward significant differences in neutralization titers between groups (4-fold (2–17.8) in the 2-h group, 16-fold (4–32.9) in the 26-h group; P = 0.06), whereas other specificities did not differ (P = 0.16–0.72). No intergroup differences were found for side effects; no athlete reported a loss of training time due to the vaccination or its side effects. Conclusion Infection prophylaxis in elite athletes by influenza vaccination seems to be effective and safe. Timing of vaccination after prior training does not seem to require specific constraints.

Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people

“…Athletes are recommended to receive all necessary vaccines before competition due to increased risks of viral exposure ( 10 ). A recent study in elite German athletes found that the quadrivalent inactivated influenza vaccine evoked a strong immune response with no reported side effects or loss of training ( 11 ). However, due to emerging reports (albeit mostly anecdotal) of adverse symptoms associated with COVID-19 vaccines, there is a growing concern among the athletic community that vaccination might hinder athletic performance.…”

Recent COVID-19 vaccination is associated with modest increases in the physiological demands to graded exercise

“…It is generally recommended that elite athletes receive all necessary vaccines prior to competition due to increased risks of viral exposure (7). A recent study in elite German athletes of 10 different types of sport found that the quadrivalent inactivated influenza vaccine (a synthetic vaccine consisting of four inactivated influenza viruses) elicited a strong immune response one week after vaccination with no reported side-effects or loss of training (8). However, due to increasing reports (albeit mostly anecdotal) of adverse symptoms associated with COVID-19 vaccines, there is a growing concern among the athletic community that vaccination might hinder athletic performance.…”

Infectious diseases and football – lessons not only from COVID-19

“…Special vaccination guidelines for elite athletes have been suggested in order to adjust to specific needs, for example, before travelling to endemic areas (Gärtner and Meyer 2014). And it has been shown recently that there is neither some kind of 'immunosuppression' from long-term elite training nor an acute influence from training sessions on vaccination effectiveness (Ledo et al 2020;Stenger et al Forthcoming). Albeit without experimental evidence, it is plausible to assume that professional football training, as it is commonly performed in these days, does not impair immune function relevantly, either.…”