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Collie S, Saggers RT, Bandini R, Steenkamp L, Champion J, Gray G, Bekker LG, Goga A, Garrett N, Patricios J. Association between regular physical activity and the protective effect of vaccination against SARS-CoV-2 in a South African case-control study. Br J Sports Med 2023; 57:205-211. [PMID: 36280289 DOI: 10.1136/bjsports-2022-105734] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Both vaccination and physical activity have been shown to independently decrease the likelihood of severe COVID-19 infection. OBJECTIVE To assess the association between regular physical activity and vaccination against COVID-19 among healthcare workers. METHODS A test negative case-control study design was used to estimate the risk of having an associated COVID-19-related hospital admission, among individuals who were unvaccinated compared with those who were fully vaccinated with Ad26.COV2.S (>28 days after a single dose). 196 444 participant tests were stratified into three measured physical activity subgroups with low, moderate and high activity, to test the hypothesis that physical activity is an effect modifier on the relationship between vaccination and hospitalisation. RESULTS Vaccine effectiveness against a COVID-19-related admission among vaccinated individuals within the low activity group was 60.0% (95% CI 39.0 to 73.8), 72.1% (95% CI 55.2 to 82.6) for the moderate activity group, and 85.8% (95% CI 74.1 to 92.2) for the high activity group. Compared with individuals with low activity levels, vaccinated individuals with moderate and high activity levels had a 1.4 (95% CI 1.36 to 1.51) and 2.8 (95% CI 2.35 to 3.35) times lower risk of COVID-19 admission, respectively (p value <0.001 for both groups). CONCLUSIONS Regular physical activity was associated with improved vaccine effectiveness against COVID-19 hospitalisation, with higher levels of physical activity associated with greater vaccine effectiveness. Physical activity enhances vaccine effectiveness against severe COVID-19 outcomes and should be encouraged by greater public health messaging.
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Affiliation(s)
- Shirley Collie
- Healthcare Analytics, Discovery Health, Johannesburg, South Africa
| | - Robin Terence Saggers
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.,Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Rossella Bandini
- PRINCE: Project to Improve Neonatal Care, School of Clinical Medicine, Faculty of Health Sciences, Wits University, Johannesburg-Braamfontein, Gauteng, South Africa
| | | | - Jared Champion
- Healthcare Analytics, Discovery Health, Johannesburg, South Africa
| | - Glenda Gray
- COVID-19 Research Committee, South African Medical Research Council, Tygerberg, South Africa
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, University of Cape Town, Observatory, South Africa
| | - Ameena Goga
- COVID-19 Research Committee, South African Medical Research Council, Tygerberg, South Africa.,Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - Nigel Garrett
- Centre for the Aids Programme of Research in South Africa, Durban, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Jon Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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