Effect of BNT162b2 mRNA booster vaccination on VO_2max in recreational athletes: A prospective cohort study

Abstract

Background and Aims The goal of the present study was to systematically evaluate the effect of a booster vaccination with the BNT162b2 messenger RNA (mRNA; Pfizer‐BioNTech®) vaccine on maximum oxygen uptake (VO 2 max ), potential signs of (peri)myocarditis, and sports participation. Methods Recreational athletes who were scheduled to undergo booster vaccination were evaluated with transthoracic echocardiography, serum measurements of high‐sensitivity C‐reactive protein(hsCRP) and high‐sensitivity troponin I, and a bicycle cardiopulmonary exercise test (CPET) with serum lactate evaluation before the booster vaccine administration. Seven days postvaccination the test battery was repeated. Additionally, the subjects were asked to fill in a questionnaire on side effects and a subjective evaluation of their relative training volume and intensity as compared to the weeks before vaccination. Results A group of 42 analysed athletes showed a statistically significant 2.7% decrease in VO 2 max after vaccination (mean standard error of mean pre: 48.6 (1.4) ml/kg/min; post: 47.3 (1.4) ml/kg/min; p = 0.004). A potentially clinically relevant decrease of 8.6% or more occurred in 8 (19%) athletes. Other CPET parameters and lactate curves were comparable. We found no serological or echocardiographic evidence of (peri)myocarditis. A slight but significant increase in hsCRP was noted 1 week after vaccination. Side effects were mild and sports participation was generally unchanged or mildly decreased after vaccination. Conclusion In our population of recreational endurance athletes, booster vaccination with the BNT162b2 mRNA vaccine resulted in a statistically significant decrease in VO 2max 7 days after vaccination. The clinical impact hereof needs to be further determined. No major adverse events were observed.

Cardiac sequelae in athletes following COVID-19 vaccination: evidence and misinformation

“…Only eight athletes were unable to train on the day of vaccination, of which seven resumed training 1 day later. A study investigating oxygen consumption (VO2) max 7 days after administration of BNT162b2 mRNA booster vaccinations in 42 recreational athletes found a small but statistically significant decrease in VO2 max 13. Although extended sports restrictions generally result in decreased exercise capacity, the advised 3-day resting period is insufficient to explain the VO2 max decrease.…”