A client perspective on massage treatment after vaccination and why we may be a little confused.
Before working for Ideal Massage, I really hadn't given much thought to massage and how it may impact health outcomes after vaccination. I mean, who does? Ok, ok. Maybe massage therapists do, but as a client, it definitely was not on my radar.
After working the front desk now for 8 months, I am by no means an expert in massage. I do feel I learn new things everyday, discovering new information that I just hadn't considered before because I didn't have to. Coming to work for Ideal Massage after the COVID-19 pandemic and the release of the vaccine, one of the first surprises I learned was that you shouldn't get a massage after getting vaccinated.
If you are saying "wha-?!" and making a confused face, yeah that was me too. I remembered the pediatrician telling us to massage the sight of injection for my infant niece's first vaccine. I started to question if anyone knew anything- if the doctors were saying one thing and the massage therapists were saying the opposite. That's when I, the proverbial Alice, fell down the rabbit hole of why massage therapists may not recommend massage after vaccination, but some doctors might.
As it turns out, there is some evidence that massage can be helpful for boosting the immune system after vaccination. The two studies I saw multiple times linked in other blogs, conversations, Reddit and, of course, on Google were about the TDaP vaccine and Hepatitis B vaccines. Both studies took different approaches, had different methods, different results and studied different demographics.
In the briefest terms, the studies were as follows: The former study, TDaP vaccine, took place in Taiwan and studied the results of massage on infants. It concluded that massage increased the likelihood of post vaccination symptoms (such as fever), but also resulted in a greater number of antibodies and improved immune response. The latter, Hepatitis B vaccine, was a trial for college students that showed a lesser number of antibodies (or a diminished immune response) in the massage group. As a result, the study postulated additional research may be necessary on the duration of treatment and modalities in stimulating immune response. See below for sources.
The two studies themselves, really aren't comparable. I mean, one looked at infants and the other looked at immune responses in college aged students. They both used different conditions for the massage treatment, which could account for differences in outcomes. And they were both studying immune responses to different vaccinations and therefore, different potential illnesses. So, it's really not fair to say that there is misleading evidence to the efficacy of massage in boosting the immune system based on these studies alone. Luckily, there are other studies as well.
Something else to keep in mind is that studies often control for various health conditions. This means that not every person is represented in these studies, so it may be true for one person, or even a group of people, but not all. Studies often rule out individuals with serious health conditions that may skew the results of their study. This isn't really a bad thing in that it helps us understand how treatments may work on healthy persons and provides consistency to the research, so they can rule out effects that may be a result of something else. But it also means that we can't know for sure how someone with a compromised immune system, or other health condition, would respond to the same treatment without additional, more specific, studies.
Either way, most professionals seem to agree that more research is needed. I think that's the tagline for pretty much all of science and medicine.
Ideal Massage's policy is to wait 48 hours between the time of your vaccination and your next massage. While we understand this may be inconvenient, it is in an effort to ensure your safety on the table. If you experience any symptoms as a result of a vaccine, such as fever, please wait to book your appointment until after symptoms have receded.
So, why is your therapist so sure you need to wait?
To be honest, they are not sure. From what I've seen, keeping in mind everything is now colored by COVID-19, different therapists across the US (and the globe) all handle these cases differently. These differences may be a result of differences in regulation, practice, training or just preference. Some therapists may treat it as a contraindication for that particular area, meaning if you get an injection in the arm, they won't touch that arm. Others treat it like there is no contraindication and may have you fill out liability waivers or skip them entirely. And then there are those who will ask you to wait 2-4 days (which is about the time they'd expect you to see any adverse reactions to the vaccine if you were to have any).
The real reason for this is liability. In some areas of the United States, such as here in Florida, Licensed Massage Therapists are held accountable to the Hippocratic oath, "do no harm", just like any other medical professional. Because that's what massage is, it's a medical treatment. As a result, your therapist is knowledgeable about a lot of things regarding the human body. However, no one profession is an expert in all of medicine. Pharmacology, pathology, immunology... that's not something the average therapist is an expert in. So, knowing that massage can influence your body's immune, lymphatic, limbic and some other systems of the body, your therapist suggests you to wait because of...
Ethics.
That's right, the problem posed by vaccines with massage therapy is an ethical one. Massage therapists can't say for sure that giving you the massage will help you and your immune system, but they also can't say that it won't hurt you. Endeavoring to do no harm, your therapist denies the service and asks you to wait because they just don't know if the service will do you harm. While some independent massage therapists may handle things differently, denying service may be a more common response in office settings.
And there it is. At the end of the day, there is no right or wrong answer as research is still needed in much of medicine and massage therapy to fully understand our body's natural responses to massage. What's most important is that therapists are accountable to safety regulations. And where safety regulations don't have an easy answer, you may find some therapists are more cautious than others. As an individual with a compromised immune system, I respect my therapists more for making that tough call and their willingness to lose pay because they are looking out for me. So, I am happy to wait two days after my flu vaccine so I can really enjoy my massage.
When I embarked into researching this topic, I hadn't realized the topic would be so contentious, even among therapists. Being a client, and being confused by the noise of the internet, I thought I should share what I found. What is it our teachers always said in school? If you have a question, then someone else likely has the same question...
Still have questions or want to share feedback? Leave us a comment below and let us know what you think.
Disclaimer: This post was written by Vik Wiggins, a staff member of Ideal Massage as a Front Desk Manager. Vik is not a Licensed Massage Therapist or doctor and was paid for the creation of this content. The opinions in this blog are not a representation of the opinions or beliefs of Ideal Massage and it's owners. If you have questions or concerns regarding medical treatments or ailments, please speak with your doctor.
The following articles were used for this article:
Hsu CY, Huang LM, Lee CY, Lin TY, Lee PI, Chen JM. Local massage after vaccination enhances the immunogenicity of diphtheria-tetanus-pertussis vaccine. Pediatr Infect Dis J. 1995 Jul;14(7):567-72. doi: 10.1097/00006454-199507000-00003.
Loft P, Petrie KJ, Booth RJ, Thomas MG, Robinson E, Vedhara K. Effects of massage on antibody responses after hepatitis B vaccination. Psychosom Med. 2012 Nov-Dec;74(9):982-7. doi: 10.1097/PSY.0b013e31826fb7d2. Epub 2012 Oct 15. PMID: 23071344.