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Hard Covid lockdowns that saw people stuck indoors and limited outdoor exercise may have undermined the effectiveness of vaccination programmes. This is the conclusion of a study out of South Africa which found that the Johnson & Johnson vaccine was three times more effective at averting hospital admission from among those who got more than 150 minutes of moderate exercise per week, compared with their low-activity counterparts. The research adds to previous findings that have suggested that regular physical activity can help protect against severe COVID-19 infection.

Covid lockdowns —  saw people largely confined to their homes — and also involved the closure of many parks and fitness centres. According to Sport England, the number of adults in England who got in the recommended 150 minutes of exercise per week fell by 710,000 in the period from November 2019 to November 2020 compared to the same period a year before.

Paper author and sports medicine expert Professor Jon Patricios of the University of Witwatersrand in Johannesburg told the Telegraph: “In terms of policy, retrospectively we can say that those hard lockdowns were counterproductive from an immune point of view.

“At that stage, policy makers based decisions on what they knew at the time, and that was largely fear driven.

“Now we know what we know, we would encourage people to exercise. We’ve always understood that physical activity has a protective effect against non-communicable diseases, but now we know we can protect against viral infection.”

In their study, Prof. Patricios and his colleagues analysed anonymised health, vaccination and physical activity data on 196,444 South Africans who belonged to both a medical insurance scheme and a programme intended to promote healthy living.

The subjects were divided into three groups based on their levels of physical activity in the two years prior to the study. Those in the low activity group engaged in less than 60 minutes of moderate intensity physical activity per week, moderate 60 to 149 minutes and high more than 150 minutes.

Among the high physical activity group, the team found that subjects who had been fully vaccinated — specifically with the Johnson & Johnson jab — were 86 percent less likely to be admitted to hospital with COVID-19 than their unvaccinated peers.

In contrast, the vaccine effectiveness was reduced to 72 percent among those in the moderate physical activity cohort and just 60 percent in the low activity group.

Prof. Patricios said: “Those who were fully vaccinated and who clocked up high weekly levels of physical activity were nearly three times less likely to be admitted to hospital than those who were vaccinated but in the low physical activity category.

“Similarly, those in the medium physical activity category were nearly 1.5 times less likely to be admitted to hospital with Covid.

“The findings suggest a possible dose–response where high levels of physical activity were associated with higher vaccine effectiveness.

“This substantiates the WHO [World Health Organization] recommendations for physical activity — namely, that 150 to 300 minutes of moderate intensity physical activity per week has meaningful health benefits in preventing severe disease, in this context against a communicable viral infection.”

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According to Prof. Patricios, the exact mechanism by which physical activity enhances vaccination efficacy is not clear, “but may be a combination of enhanced antibody levels, improved T cell immunosurveillance, and psychosocial factors.”

The sports medicine physician added that mitochondria — the energy-producing organelles of cells — play an important role in the body’s immune response.

It is his theory that physical activity helps to maintain mitochondrial quality by boosting the rate at which the organelles are repaired, grown and replaced.

Prof. Patricios concluded: “Public health messaging should encourage physical activity as a simple, cost-effective way of enhancing vaccine effectiveness to mitigate the risk of severe COVID-19 illness requiring hospital admission.”

The full findings of the study were published in the British Journal of Sports Medicine.

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