Older people should increase exercise prior to Covid-19 vaccination – report

Trinity team outlines ways to boost uptake, efficacy of vaccine among vulnerable group

Regular aerobic or moderate exercise in weeks and months prior to Covid-19 vaccination can help improve antibody responses post vaccination in older people, according to researchers at Trinity College Dublin.

The recommendation is outlined in a report by scientists leading the on-going Irish Longitudinal Study on Ageing (Tilda). Adults aged 60 and older should consistently incorporate some form of exercise such as a brisk walk at least two to three times per week prior to vaccination, they conclude.

As vaccination of the Irish population is rolled out, it is critically important that lessons from previous vaccination programmes among older adults are used to inform current efforts, their report says.

Vaccine efficacy in older adults can be a challenge due to ageing effects on the immune system. As people age, ability to produce robust antibody responses following vaccination declines; they are less likely to generate long-term protection often required for full immunity to a virus.

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Communication

Tilda researchers evaluated information on flu vaccine uptake and health behaviours which govern vaccine efficacy, ahead of rollout of the Covid-19 vaccine for older adults.

Their report analyses data from Tilda participants between 2016 and 2019, outlining prevalence of flu vaccination and levels of physical activity among those who received the vaccine – notably evidence showing the positive effects of prolonged physical activity on vaccine efficacy.

The report shows 65 per cent of participants accessed information via national radio channels; 43 per cent accessed information via national newspapers, and less than 7 per cent of older adults accessed public health information through government websites. “This is an important consideration when communicating messaging on the vaccine,” they underline.

Other findings include:

– 59 per cent of adults aged over 60 had an annual flu vaccination between 2016 and 2019;

– More older people received the vaccine, 40 per cent aged 60-69 compared with 76 per cent aged 70 and older;

– Those aged 60-69 years are less likely to be vaccinated including those who live in rural areas and those who are in employment;

– 44 per cent of adults aged over 60 in Ireland do less than the recommended level of physical activity for cardiovascular health, for enhanced immunity and vaccination responsiveness;

– Public health campaigns should target groups less likely to meet minimum recommended physical activity levels: ie women; adults aged 75+; individuals with a primary level of education or none and those who live in urban areas;

– Covid-19 vaccine information should be communicated via trusted news sources where adults over 60 might access information.

30-minute walk

Tilda's principal investigator Prof Rose Anne Kenny said their findings provide strong evidence and positive guidelines for rolling out a successful vaccination programme targeting older adults.

“Any action which will boost immunity and in particular the immune response to the SAR2CoV vaccine is very important. Moreover, Tilda’s report indicates the appropriate channels of communication to reach older adults with effective messaging since the start of the pandemic, a key element in promoting the uptake of vaccination in older adults,” she added.

In addition to the usual benefits of physical activity like improved mood and wellbeing, evidence indicates being more active can help to boost vaccine specific antibody responses particularly among older adults, said TCD School of Medicine research fellow Dr Cillian McDowell. “Some activity is good, but more is better, and a good goal would be a 30-minute walk brisk enough to increase your breathing rate, done two to three times per week.”

Dr Siobhán Kennelly of the HSE's Social Care Division said maximising the impact of vaccine effectiveness in the context of the pandemic would be crucial to reducing susceptibility of older people. The Tilda findings were important and should be emphasised in communications targeted at these groups, she believed.

“Free and accessible vaccination with high levels of publicity have influenced the significantly increased uptake of influenza vaccination in all people aged over 65 this winter,” she added. “This should continue be an important part of public health provision in future vaccination programmes.”

Kevin O'Sullivan

Kevin O'Sullivan

Kevin O'Sullivan is Environment and Science Editor and former editor of The Irish Times