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Training around your first/second COVID-19 vaccination

 

In late January, I was eligible to receive my first Covid-19 Vaccine from Pfizer. As a licensed dietitian in the state of South Carolina, I took advantage of the opportunity to be part of the solution of this serious pandemic. I was hesitant at first as I never get the flu shot, I never take antibiotics and I rarely ever take ibuprofen. I consider myself to be very healthy and I feel that my immune system is very strong. But putting my trust into science and into people in the medical field, I realized quickly that the vaccine wasn't just about me - it was about helping to stop the spread of COVID-19. In other words, being vaccinated wasn't about my health but how my health would impact the health of others. On January 27th I received my first vaccine and on Feb 22nd I received my second dose. 


Karel wasn't eligible until late March and he had no hesitations or worries about receiving the vaccine. He joked that he grew up in a communist country so who knows what "medicine" he was being told he needed to receive from the authorities. On March 29th, Karel received his first dose of Pfizer and on April 21st, he received his second dose. Neither Karel or myself took any anti-inflammatory pills or OTC flu-like medicine after either vaccination as we did not want anything to impact our immune system response. 

I felt extremely lucky to be in one of the first "public" groups to get vaccinated in the US as I eventually wanted to share my experience with the vaccine and training. However, I had no side effects with either vaccine and nothing has changed with my health. Again, I didn't feel that I needed the vaccine and to be honest, was not too comfortable at first with the whole idea of being vaccinated but I reminded myself that this was not about me. Karel also had no side effects. But seeing that over half of our coached athletes have been vaccinated over the past few months, I wanted to share their experience and how we went about scheduling training for our athletes before and after their vaccination. Seeing that more athletes may be getting vaccinated in the next few months (especially since the city of Lake Placid is requiring all participating athletes, volunteers and staff to be vaccinated), we thought the following may be helpful for other athletes and coaches. We have never told or encouraged our athletes to get the vaccine but instead, worked with our athletes based on their individual situation. 

We are not medical professionals and only have our own experience to go by and as coaches (and as athletes), we are learning as we go along. It's a personal decision if you choose to get or not to get your vaccine but I do worry about the health of athletes receiving their vaccines around higher volume/training and racing, so for those who do plan to get the vaccine sometime soon, I hope you find this blog post helpful. 

Training around the vaccination date 
(what we have learned based on athlete feedback)
  • We advised our athletes to tell us when they are receiving their first and second vaccine so that we could put the date/time into Training Peaks (where we deliver training/workouts). We treated the vaccine as any other important "task" that we needed to know about. 

  • We did not find that training needed to be modified in the days leading up to the vaccine. We kept with the normal progression of training for each individual athlete.

  • We did not adjust training on the morning of receiving the vaccine. Some athletes trained hard, others trained easy. We considered how the athlete may respond to the vaccine when deciding what workout to prescribe on the morning before receiving the vaccine later in the day. There was no way to know exactly so we just used our best judgement based on the prior health of the athlete (some athletes are more vulnerable to stressors than others). 

  • Depending on the time of the day for receiving the vaccine, we planned an easy "optional" swim after receiving the vaccine depending on how they felt (and time constraints). Because arm soreness is a consistent side effect of the vaccine, many athletes felt as if swimming in the hours after receiving the vaccine helped reduce soreness. Many athletes expressed being tired in the hours after the vaccine so not having an evening workout allowed for early-to-bed. 

  • For the majority of our athletes (not all, depended on the athlete and their feedback after the vaccine), we did not prescribe specific training the day after receiving the first vaccine - just to see how the athlete responded. This allowed the athlete to sleep in as many athletes expressed being a bit more tired than normal in the evening of receiving the vaccine. Regardless of side effects, we wanted the vaccine to to be the priority for the immune system, not training. 

  • Athletes were typically given an optional easy swim or spin right after or the day after the 1st vaccine. But if they emailed us and said they felt ok, we let them proceed with normal training the next day - if they did not have any side effects the next morning after the vaccination.

  • Since there was a strong trend for more significant side effects after the 2nd vaccination, we prescribed no workout or just an easy swim or spin the next day after the 2nd vaccine. We allowed at least 24 hours for the vaccine side effects to occur after the 2nd vaccine and if the athlete felt ok after 24 hours, we proceeded with normal training. Just a few athletes had flu-like side effects for more than 24 hours (most after the 2nd) so we continued with no training (depending on symptoms) or optional exercise (primarily easy biking) if the athlete just felt "off" but no flu-like symptoms. Only a few of our athletes were unable to exercise for 48 hours but almost all of our athletes were able to get back into normal training after around 72 hours. And unlike the flu, the side effects instantly went away and did not linger. 

  • If an athlete expressed any side effects from the vaccine beyond a sore arm (ex. flu-like, fatigue, etc.), we treated it like a true sickness and based training on symptoms. If an athlete did have serious flu-like symptoms, we waited until the athlete was back to 90% optimal health + 1-2 more days before easing back into training. 

  • Because we communicated with our athletes to be smart with training around the vaccination, the majority of our athletes did a great job listening to their bodies and even if we had scheduled an optional or easy workout, we encouraged them to listen to their body to decide if that easy workout made sense to complete or not. Of course, even if we prescribed to take it easy or to listen to the body, you know how athletes are with "red box syndrome" in Training Peaks..... ;) 

  • As for scheduling your vaccine (especially now that many athletes are in higher volume/intensity training and racing), I suggest to allow 24-48 hours after a hard/intense training session or race before receiving the vaccine and to allow yourself another 48-72 hours to ease back into training after receiving the vaccine. In other words, I don't suggest to get the vaccine the week of or the day after a race or in the 48 hours right before or after a hard few days of training. Because intense or high volume exercise impacts the immune system (as does the vaccine), it's best not to double-up with a double hit to the immune system. 
Athletes who had COVID (not vaccinated)

Only four of our 40+ coached/team athletes were tested positive for COVID (one couple, one in UAE and one male athlete). Three are in their 30's and one is in her 40's. All are back training and racing again. Symptoms varied for these athletes from fatigue, no energy, chills, loss of appetite and extreme sleepiness for at least 4-7 days. We did not prescribe training for these athletes until they expressed feeling 90% back to optimal health and then we waited another 2-3 days. 

Here are two good reads about exercising after being tested positive for COVID: 
Exercise After Covid? Take it slow.
Vaccine Side Effects
We asked several of our athletes to share their experience with the vaccine. Here are some of their responses over the past few months. As a summary of our coached athlete/team demographics, have around 100 athletes part of our team, we coach 50 athletes. The age range of our athletes is between 34-64 years of age. We coach endurance athletes training for long distance triathlon. Most of our athletes are based in the US with a few athletes in UK, Czech and UAE.

  • I received the Pfizer vaccine a few weeks ago (late morning in the middle of the work day) & will be receiving my 2nd dose Tuesday. My arm/shoulder muscle was sore that evening, enough that I actually took some Tylenol. I did my normal workouts (I was on a lighter week anyway) the next day & by the next evening my arm wasn’t really even sore any more. I got my 2nd dose yesterday late morning. Later that day a little arm soreness like the first dose, but my head felt a little swimmy & I felt more tired than usual. I came home & did my planned strength workout (rather intense) & a 20 minute cool down run. As soon as I stopped I noticed my head pounding, a queasy stomach, body aches & fatigue. This continued overnight & I still feel yucky today so I’m going to skip my workouts this morning & if I fee up to it tonight do some yoga & mobility/core work. But I’m mostly gonna let my body do it’s thing & let the vaccine do it’s job. I still plan on working today & may take some Tylenol if needed, I could probably push through a run or bike this morning but it wouldn’t be pretty & wouldn’t be effective training.

  • Yesterday at 2:00 pm I received my 1st COVID Vaccine (Pfizer). No real side effects other than a sore shoulder which caused me to loose a bit of sleep. At 9:00 am this morning, I set out to get in a 1 hour and 40 minute run. The run was good, but knew I was carrying more fatigue than normal for a morning run. Most likely caused by reduced sleep and of course, the vaccine. Then I had a 3,100 yard swim. I really felt the fatigue early on in this swim and it took about 1,000 yards to really get my left shoulder (shot location) loosened up. While I did complete all of the sets in my swim workout, I did give myself permission to take longer rests between some of the sets than I normally would. I completed both workouts and thanked my body for being so amazing!!!

  • I had the moderna vaccine last Monday. 1st dose. My arm was quite sore Tuesday and Wednesday. Was able to swim Tuesday but felt it the whole time. Had a little difficulty sleeping on my left side as it hurt to roll on to it. I took ibuprofen the 2nd night which helped. Taking the second dose in 3 weeks. So I got my second vaccine dose 4 weeks after my 1st. Moderna. It was a 4pm injection. Had anxiety anticipating not feeling well in the morning. Ended up being fine until about 12 the next day. Starting feeling like I was coming down with the flu. Achy all over, mild fever and cold. Chills like crazy. Couldn’t get warm until I got home. Took two ibuprofen and had two mugs of hot tea. Felt normal by 8pm that night. Had some residual fatigue for about two days after. Took the day after symptoms appeared off from workouts but was able to resume on Wednesday of that week. Have had no other issues sense and am very happy I got vaccinated. I believe these were a miracle of modern medicine and am very appreciative that they were developing so quickly.

  • I got my 1st dose of the Moderna vaccine Tuesday morning January 12th. For Tuesday night, Wednesday, and Thursday, my arm was pretty sore. I ended up taking Tylenol Wednesday and Thursday because it woke me up when I'd try to sleep on that side. My swim on Wednesday was uncomfortable but doable. I was back to normal in the pool on Friday. Other than that, the only other thing I noticed was that my higher end of range work felt harder for my Thursday bike but my low range was fine. I can't say for sure whether it was the vaccine or hormones though.
  • I will also update when I get my 2nd dose on Feb. 9th. 
  • I received my first vaccine on December 30, the Pfizer vaccine. I had no soreness at the site following and no side effects. I did choose to take the day after as a rest day, though I did not feel like physically I needed it I wanted to give my body a chance to do what it needed to do. I am scheduled for my second Pfizer vaccine on Wednesday at 1 o’clock, and will keep you posted. I have had several nursing friends who felt just fine after the second dose and several who actually woke up the following day with fevers, headaches and body-aches that lasted 1 to 2 days. that round two goes as smoothly as as round one! Update - I received my second vaccine on Wednesday! I woke up the following morning feeling great! No fever body-aches or headache! I did notice muscle tenderness at the site of injection. However that did not interfere with my work out or activities of daily living.

  • I got my first Pfizer dose on Friday 12/18... As someone who doesn't react to vaccines, I had quite the sore arm for 24-36hours afterwards. I also had some mild fatigue. I adjusted my workouts to include easier and shorter efforts with some mobility. My second dose was on Friday 1/8... as predicted, there were more fireworks with this one. I had my shot at noon on Friday, had a great low-stress swim that afternoon, then woke up at 1am with bad full-body muscle/joint aches. I began taking Tylenol extra strength every 6-8 hours all through Saturday into Sunday am. I felt very fatigued and achy all through Saturday while riding the couch. I never registered a temp, but felt my body's thermostat was whacky (flush/chills)... got a good night sleep Saturday night and woke up feeling oddly fine on Sunday. It was a strange experience feeling so crappy one day and feeling perfectly fine the next. I'm glad I let my body rest on Saturday and eased back into it on Sunday... just an EZ bike/short brick run Sunday. Many of my coworkers have already received their second dose and most have had robust reactions to it including fatigue, body aches (most common), low grade fevers, redness/pain at the injection site, headaches... basically flu-like symptoms that last 1-5 days. There are a few coworkers who just experienced a sore arm and that was IT! I had/still have lots of questions about this vaccine; however, after my first shot I was pretty emotional thinking about how much covid has changed my life over the past year... my workplace at the hospital, my connection with my patients, my ability to race and train with others, how I function to protect my husband....if this is the key to changing the tide, I am thrilled to be a part of it. As triathletes, we are incredibly conscious about what we put in our bodies and I tried my best to find answers to my questions before I got the vaccine. I have found that the temporary reaction that I had to that second shot is well worth the potential of mitigating/eradicating covid in our lives. I know I can still technically catch covid, but my symptoms are supposed to be mild-asymptomatic. I am also protected from the long-term effects of covid that we are not hearing too much about. Sorry for the long post... just wanted to share my journey with this vaccine and acknowledge how truly amazing the human body is!

  • I got my 1st vaccine yesterday. I got the Moderna - which made me a bit happy because I know one of the guys who helped develop it. My arm is kinda sore today but so far so good. For me getting the vaccine was my way of helping get the little kids in my neighborhood back to school, to see their friends and have some of the joy and freedom my kids enjoyed growing up.

  • Got my Pfizer vaccine last Friday right after swim practice. Had a sore shoulder over night. Restless sleep that nigh. A little fatigue next day but could have been also from training stress of week and bad night sleep. Took a nap midday after kids soccer and then got back to my regular training with a long treadmill run that evening. Then regular gravel riding on Sunday.

  • I got mine day before yesterday. Localized pain at site. Next day (yesterday) I was awful—side effects being cold with aches, headache and really tired/lethargic and all those good things that make you feel like you have the flu and you just got a tetanus shot. Today, I’m perfectly fine and my arm only feels like it has a bruise. First dose Moderna.

  • I had my first dose of Moderna 1 week ago. I had mine around lunchtime and felt fine until about lunchtime the next day. I started feeling really nauseous and that lasted about 1.5 days. I also felt really thirsty starting a few hours after the injection. I was drinking extra water already but it didn’t seem like enough. I made sure I got extra sleep each night. I also had a big week of training but still felt ok during my workouts. I left the option open if I didn’t feel good, I would ask for workout adjustments. Arm was sore for about 2 days but moving it around seemed to help (some strength and swimming). My husband (also a triathlete), had Moderna 1 day before me and said he had a sore arm and just felt a little tired but no other symptoms. My boys (age 16 and 17) will get the Pfizer vaccine tomorrow.

  • I received 2 doses of the Pfizer vaccine. The only side effect I experienced was soreness in my arm for 2-3 days. Fortunately, no other symptoms.
If you would like to do more research before receiving the vaccine, please use reputable scientific websites (not blogs of health and wellness influencers) like this one. 

Because COVID-19 is still a virus that researchers and scientists are still learning about, it's better to err on the side of caution and to be a little extra smart and safe with training than to take risks. The first vaccination against the influenza virus was in 1930. The first case of COVID-19 in the US was January 2020. It's a miracle that we have a vaccine that is safe and effective but as it relates to the virus itself, we still don't know the long-term effects but we surely know that the virus is highly contagious and deadly for many susceptible people. Sadly, Karel's 80-year old dad passed away from catching COVID in February when a caretaker came into his apartment to cut his hair or to check on him (he never left his apartment). He was diagnosed with COVID in the hospital after feeling sick, stayed in the hospital for a few days and then passed away a few days later at home - after expressing he was unable to breathe, he suffered from a heart attack. Karel was unable to travel to Czech due to a lockdown in the country. As you can imagine, not being able to be at his dad's funeral (watching it online) and not being able to be with his mom and brother was tremendously hard. My grandmother also passed away from COVID. She slipped on her patio, broke her hip and had surgery. When she entered the nursing home for rehab, she tested positive for COVID and passed away a few days later at the age of 91. COVID attacks the lungs and the heart and that is why athletes need to be extra careful with the virus. For us, the pros of the unknown long-term effects of the vaccine outweighed the known short and long-term effects of COVID. Since me and Karel have both been personally impacted by COVID taking the lives of our family members, we view this virus very differently than those who have not been impacted. Certainly, it's important to be respectful of different opinions and beliefs during this difficult time in our life. 

This blog post is dedicated to Karel's dad and my Grandma.