Vaccine, as a preventive biological agent, has been widely used. However, due to age, chronic diseases, malnutrition, improper lifestyle and other factors, the immunological efficacy of vaccine is often not up to people's expectations. Research on how to improve vaccine effectiveness has important clinical implications. Exercise, as a behavioral adjuvant, has been shown to play an adjunct role in the immune response to many vaccines. In this paper, the benefits of exercise in different vaccine types are discussed, and the main factors are further analyzed. The results showed that the strengthening effect of exercise might be related to the type of vaccine, and was affected by age, sex and exercise form.

Yuan Rui. Review of Research Progress on the Effect of Exercise on Vaccine Immune Response. Academic Journal of Medicine & Health Sciences (2024), Vol. 5, Issue 8: 7-13. https://doi.org/10.25236/AJMHS.2024.050802.

[1] Weyh, C., K. Kruger, and B. Strasser, Physical Activity and Diet Shape the Immune System during Aging. Nutrients, 2020. 12(3).

[2] Edwards, K.M., et al., Acute stress exposure prior to influenza vaccination enhances antibody response in women. Brain, behavior, and immunity, 2006. 20(2): p. 159-168.

[3] Nieman, D.C., Exercise Is Medicine for Immune Function: Implication for COVID-19.Current Sports Medicine Reports, 2021. 20(8): p. 395-401.

[4] Paules, C. and K. Subbarao, Influenza. Lancet (London, England), 2017. 390(10095): p. 697-708.

[5] Edwards, K.M., et al., Eccentric exercise as an adjuvant to influenza vaccination in humans.Brain, behavior, and immunity, 2007. 21(2): p. 209-217.

[6] Edwards, K.M., et al., Exercise intensity does not influence the efficacy of eccentric exercise as a behavioural adjuvant to vaccination. Brain, behavior, and immunity, 2010. 24(4): p. 623-630.

[7] Whitham, M. and A.K. Blannin, The effect of exercise training on the kinetics of the antibody response to influenza vaccination. Journal of sports sciences, 2003. 21(12).

[8] de Araujo, A.L., et al., Elderly men with moderate and intense training lifestyle present sustained higher antibody responses to influenza vaccine. Age (Dordrecht, Netherlands), 2015. 37(6): p. 105.

[9] Bohn-Goldbaum, E., et al., Acute exercise does not improve immune response to HPV vaccination series in adolescents. Papillomavirus research (Amsterdam, Netherlands), 2019. 8: p. 100178.

[10] Edwards, K.M., et al., Acute exercise enhancement of pneumococcal vaccination response: a randomised controlled trial of weaker and stronger immune response. Vaccine, 2012. 30(45): p. 6389-6395.

[11] Long, J.E., et al., A life-style physical activity intervention and the antibody response to pneumococcal vaccination in women. Psychosomatic medicine, 2013. 75(8): p. 774-782.

[12] Long, J.E., et al., Vaccination response following aerobic exercise: can a brisk walk enhance antibody response to pneumococcal and influenza vaccinations? Brain, behavior, and immunity, 2012. 26(4): p. 680-687.

[13] Xia, L., et al., Exhaustive Exercise Does Not Affect Humoral Immunity and Protection after Rabies Vaccination in a Mouse Model. Virologica Sinica, 2018. 33(3): p. 241-248.

[14] Pence, B.D., et al., Voluntary Wheel Running Does Not Alter Mortality to or Immunogenicity of Vaccinia Virus in Mice: A Pilot Study. Frontiers in physiology, 2017. 8:p. 1123.

[15] Molanouri Shamsi, M., et al., Short term exercise training enhances cell-mediated responses to HSV-1 vaccine in mice. Microbial pathogenesis, 2017. 110: p. 457-463.

[16] Edwards, K.M., et al., Meningococcal A vaccination response is enhanced by acute stress in men. Psychosomatic medicine, 2008. 70(2): p. 147-151.

[17] Lee, V.Y., et al., The effect of exercise on local and systemic adverse reactions after vaccinations Outcomes of two randomized controlled trials. Vaccine, 2018. 36(46): p. 6995-7002.

[18] Lee, V.Y., et al., The effect of exercise on vaccine-related pain, anxiety and fear during HPV vaccinations in adolescents. Vaccine, 2018. 36(23): p. 3254-3259.

[19] Ushida, T., et al., The Effect of Guidance regarding Home Exercise and ADL on Adolescent Females Suffering from Adverse Effects after HPV Vaccination in Japanese Multidisciplinary Pain Centers. Pain research & management, 2016. 2016: p. 3689352.

[20] Al-Mhanna, S.B., et al., Physical activities pre- and post-COVID-19 vaccination and its implementations: A narrative review. SAGE Open Medicine, 2023. 11: p. 20503121231158981.

[21] Bohn-Goldbaum, E., et al., Acute exercise decreases vaccine reactions following influenza vaccination among older adults. Brain, Behavior, & Immunity - Health, 2020. 1: p. 100009.

[22] Shayea, A.M.F., et al., Effect of Physical Activity and Exercise on the Level of COVID-19 Antibodies and Lifestyle-Related Factors among Vaccinated Health Science Center (HSC) Students: A Pilot Randomized Trial. Vaccines, 2022. 10(12).

[23] Lee, V.Y., et al., Analgesic and adjuvant properties of exercise with vaccinations in healthy young population. Human Vaccines & Immunotherapeutics, 2021. 17(7): p. 2058-2064.

[24] Agustiningsih, D. and T. Wibawa, Demystifying roles of exercise in immune response regulation against acute respiratory infections: A narrative review. Sports Medicine and Health Science, 2024. 6(2): p. 139-153.

[25] Shao, T., et al., Physical Activity and Nutritional Influence on Immune Function: An Important Strategy to Improve Immunity and Health Status. Frontiers in Physiology, 2021. 12: p. 751374.

[26] Monteiro, F.R., et al., Combined Exercise Training and l-Glutamine Supplementation Enhances Both Humoral and Cellular Immune Responses after Influenza Virus Vaccination in Elderly Subjects. Vaccines, 2020. 8(4).

[27] Kohut, M.L., et al., Moderate exercise improves antibody response to influenza immunization in older adults. Vaccine, 2004. 22(17-18): p. 2298-2306.

[28] Yang, Y., et al., Effects of a Taiji and Qigong intervention on the antibody response to influenza vaccine in older adults. The American journal of Chinese medicine, 2007. 35(4):p. 597-607.

[29] Woods, J.A., et al., Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. Journal of the American Geriatrics Society, 2009. 57(12): p. 2183-2191.

[30] Sevgin, O. and S. Ozer, Effect of physical exercise on inactivated COVID-19 vaccine antibody response in the elderly. Human Antibodies, 2024. 32(1): p. 19-24.

[31] Kohut, M.L., G.W. Boehm, and J.A. Moynihan, Moderate exercise is associated with enhanced antigen-specific cytokine, but not IgM antibody production in aged mice. Mechanisms of ageing and development, 2001. 122(11): p. 1135-1150.

[32] Moynihan, J.A., et al., Psychosocial factors and the response to influenza vaccination in older adults. Psychosomatic medicine, 2004. 66(6): p. 950-953.

[33] Stupka, N., et al., Gender differences in muscle inflammation after eccentric exercise.Journal of applied physiology (Bethesda, Md.: 1985), 2000. 89(6): p. 2325-2332.

[34] Pullinen, T., et al., Resistance exercise-induced hormonal responses in men, women, and pubescent boys. Medicine and science in sports and exercise, 2002. 34(5): p. 806-813.

[35] Giron-Gonzalez, J.A., et al., Consistent production of a higher TH1: TH2 cytokine ratio by stimulated T cells in men compared with women. European journal of endocrinology, 2000. 143(1): p. 31-36.

[36] Verthelyi, D. and D.M. Klinman, Sex hormone levels correlate with the activity of cytokine secreting cells in vivo. Immunology, 2000. 100(3): p. 384-390.

[37] Ranadive, S.M., et al., Effect of acute aerobic exercise on vaccine efficacy in older adults.Medicine and science in sports and exercise, 2014. 46(3): p. 455-461.

[38] Hallam, J., et al., Exercise after influenza or COVID-19 vaccination increases serum antibody without an increase in side effects. Brain, Behavior, and Immunity, 2022. 102.

[39] Pascoe, A.R., M.A. Fiatarone Singh, and K.M. Edwards, The effects of exercise on vaccination responses: a review of chronic and acute exercise interventions in humans. Brain, behavior, and immunity, 2014. 39: p. 33-41.

[40] Edwards, K.M., et al., The acute stress-induced immunoenhancement hypothesis. Exercise and sport sciences reviews, 2007. 35(3): p. 150-155.

[41] Simpson, R.J., Aging, persistent viral infections, and immunosenescence: can exercise "make space"? Exercise and sport sciences reviews, 2011. 39(1): p. 23-33.

[42] Barni, L., et al., Does Physical Exercise Enhance the Immune Response after Vaccination? A Systematic Review for Clinical Indications of COVID-19 Vaccine. International Journal of Environmental Research and Public Health, 2023. 20(6).

[43] Ayling, K., et al., Positive mood on the day of influenza vaccination predicts vaccine effectiveness: A prospective observational cohort study. Brain, behavior, and immunity, 2018. 67: p. 314-323.

[44] Kapasi, Z.F., et al., The effects of intense physical exercise on secondary antibody response in young and old mice. Physical therapy, 2000. 80(11): p. 1076-1086.